Active NPI
Tracy Pennoyer
- Clinical Psychologist
- Westport, CT
National Provider Identifier
1992022321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002003
- Practice address
- 8 Myrtle Ave
Westport, CT 06880-3511 - Phone
- (203) 341-0495
- NPI assigned
- Apr 25, 2010
- Last updated
- Apr 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 002003 | CT | Primary |
Addresses
Primary practice location
8 Myrtle Ave
Westport, CT 06880-3511
Mailing address
90 Kettle Creek Rd
Weston, CT 06883-2222
Phone (203) 341-0495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272153600000",
"number": "1992022321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 KETTLE CREEK RD",
"city": "WESTON",
"state": "CT",
"postal_code": "068832222",
"telephone_number": "203-341-0495",
"fax_number": "203-226-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 MYRTLE AVE",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068803511",
"telephone_number": "203-341-0495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNOYER",
"first_name": "TRACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-25",
"last_updated": "2010-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
- Pearl Counseling and Wellness, PLLC
- Pearlyn Goodman-Herrick, ND PC
- Gary John Pearson, LMFT
- Pamela Sue Peckheiser, M.A.
- Samantha Penman, BCBA
- Salvatore Penta
- Perennial Wellness PLLC
- Performance Health Care Management
- Performance Physical Therapy of CT (Performance Physical Therapy)
- Performance Physical Therapy of Hamden LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.