Individual provider Active NPI

Mariana Torres-Viso

  • Clinical Child & Adolescent Psychologist
  • Glastonbury, CT
National Provider Identifier
1952840761
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
3613 Issued in CT
Practice address
2300 Main St
Glastonbury, CT 06033-2218
Phone
(860) 430-1762
NPI assigned
Feb 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 3613 CT Primary

Addresses

Primary practice location

2300 Main St
Glastonbury, CT 06033-2218

Mailing address

2300 Main St
Glastonbury, CT 06033-2218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413002521 CT Practitioner - Clinical Psychologist 9032527916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Current Accepting new patients
Yale University CurrentSince Jan 12, 2021 Accepting new patients
Yale University CurrentSince Jan 12, 2021 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1952840761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332218",
            "telephone_number": "860-430-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES-VISO",
        "first_name": "MARIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "3613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.