Active NPI
Nancy E Killian, PH.D.
- Clinical Psychologist
- Fairfield, CT
National Provider Identifier
1992838247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 060002078
- Practice address
- 1241 Post Rd
Fairfield, CT 06824-6025 - Phone
- (203) 319-0236
- Fax
- (203) 319-0236
- NPI assigned
- Mar 14, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 002078 | CT | |
| Clinical Psychologist | 103TC0700X | 060002078 | CT | Primary |
Addresses
Primary practice location
1241 Post Rd
Fairfield, CT 06824-6025
Mailing address
PO Box 831
Fairfield, CT 06824-0831
Phone (203) 319-0236
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060002078CT01 | Other | CT | ANTHEM PROVIDER ID |
| 336733 | Other | CT | VALUE OPTIONS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091203000552 | CT | Practitioner - Clinical Psychologist | 7315086352 | Practice locations: Fairfield, CT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002078 | CT | MD | Professional Counselor |
| 060002078 | CT | MD | Clinical Psychologist |
Interoperability endpoints
- nancy.killian@ctproviderdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314921600000",
"number": "1992838247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 831",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068240831",
"telephone_number": "203-319-0236",
"fax_number": "203-319-0236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 POST RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068246025",
"telephone_number": "203-319-0236",
"fax_number": "203-319-0236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLIAN",
"first_name": "NANCY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2011-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CT",
"license": "002078",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "060002078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER ID",
"identifier": "060002078CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER #",
"identifier": "336733",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.