NPIMap

Organization Active NPI

Willow Treatment & Associates, Inc.

  • Psychoanalyst
  • Hamden, CT
National Provider Identifier
1992057772
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
001265 Issued in CT
Legal business name
WILLOW TREATMENT & ASSOCIATES, INC.
Practice address
60 Connolly Parkway; Building 2C-207
Wilbur Cross Commons
Hamden, CT 06514
Phone
(203) 535-0318
NPI assigned
Oct 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Mrs. Kathryn Camizzi, APRNNPI 1760466957
Title
President
Phone
(203) 535-0318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychoanalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 102L00000X 001265 CT Primary
Prescribing (Medical) PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TP0016X 001265 CT
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X 001265 CT

Addresses

Primary practice location

60 Connolly Parkway; Building 2C-207
Wilbur Cross Commons
Hamden, CT 06514

Mailing address

60 Connolly Parkway; Building 2C-207
Wilbur Cross Commons
Hamden, CT 06514
Phone (203) 535-0318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151117003142 CT Part B Supplier - Clinic/Group Practice 2466762752 Receives reassigned benefits from 3 practitioners
Practice locations: Hamden, CT

National Provider Directory

National Provider Directory

Locations

60 Connolly Pkwy
#207
Hamden, CT 06514

60 Connolly Pkwy
Bldg 2C-207
Hamden, CT 06514
Phone (203) 535-0318

60 Connolly Pkwy
Ste 207
Hamden, CT 06514
Phone (203) 535-0318

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1992057772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CONNOLLY PARKWAY; BUILDING 2C-207",
            "address_2": "WILBUR CROSS COMMONS",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06514",
            "telephone_number": "203-535-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CONNOLLY PARKWAY; BUILDING 2C-207",
            "address_2": "WILBUR CROSS COMMONS",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06514",
            "telephone_number": "203-535-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREATMENT & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "CAMIZZI",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-535-0318",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": "CT",
            "license": "001265",
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "CT",
            "license": "001265",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "001265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.