LOGAN GREEN, PH.D. (NPI# 1548322423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548322423 |
| Entity Type | Organization |
| Organization Name | LOGAN GREEN, PH.D. |
| Practice Address |
494 Main St Apt 1 Cromwell CT 06416-2040 |
| Practice Telephone | 8606321296 |
| Mailing Telephone | 8606321296 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LOGAN GREEN (NEUROPSYCHOLOGIST) |
| Authorized Official Telephone | 8606321296 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
852 | CT | Behavioral Health & Social Service Providers |
| Street Address |
494 MAIN ST APT 1 |
| City | CROMWELL |
| State | CT |
| Zip Code | 06416-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760544720 | Michael Haymes, Ph.d. | Psychologist | 494 Main St, Suite 100, Cromwell, CT 06416-2040 | 2006-12-15 |
| 1609960327 | Michael Haymes | Psychologist | 494 Main St, Cromwell, CT 06416-2040 | 2006-10-03 |
| 1740373398 | Logan Green | Psychologist | 494 Main St, Cromwell, CT 06416-2040 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104469626 | Anjali Rowe | Developmental Therapist | 162 West Street., Building 2 Suite F, Building 2 Suite F, Cromwell, CT 06416 | 2019-10-28 |
| 1366938110 | Katherine Sluti | Developmental Therapist | 162 West St., Building 2 Suite F, Cromwell, CT 06416 | 2018-07-05 |
| 1821597477 | Sherry Wong | Behavioral Analyst | 162 West St, Bldg 2, Suite F, Cromwell, CT 06416 | 2018-02-09 |
| 1952826828 | Marlene Dejesus | Developmental Therapist | 162 West St, Bldg 2 Suite F, Cromwell, CT 06416 | 2017-08-11 |
| 1689199895 | Amanda Marie Mimande | Developmental Therapist | 162 West Street, Building 2, Suite F, Cromwell, CT 06416 | 2017-08-08 |
| 1912260357 | Ulrich Klaus Rathey | Internal Medicine | 2316 Cromwell Hills Drive, Cromwell, CT 06416 | 2012-06-20 |
| 1801171616 | Leonard J Zgorski | Pharmacist | 4 Hammerhead Place, Cromwell, CT 06416 | 2011-10-13 |
| 1396024725 | Michelle Nwigwe | Nurse Practitioner | 80 Shunpike Rd Ste 101-b2, Cromwell, CT 06416 | 2011-08-16 |
| 1508090028 | Giovanna Maria Cammuso | Social Worker | 22 Tuttle Road, Cromwell, CT 06416 | 2009-05-12 |
| 1992954994 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 72 Berlin Rd., Cromwell, CT 06416 | 2008-09-15 |
| Find all providers in zip 06416 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497084107 | Stephanie Leite | Psychologist | 12 Merrywood, Simsbury, CT 06070-2613 | 2009-12-09 |
| 1609105972 | Deborah Gruen | Psychologist | 4 Whitney Street Ext, Westport, CT 06880-3768 | 2009-12-16 |
| 1699008326 | Caren Beth Teitelbaum | Psychologist | 200 Retreat Avenue, Hartford Hospital Psychiatry Dept, Hartford, CT 06106-3310 | 2009-09-14 |
| 1578783361 | James J Connolly | Psychologist | 758 Broad Street Ext, Waterford, CT 06385-1345 | 2007-04-26 |
| 1386782977 | Applied Behavioral Sciences LLC | Psychologist | 68 S Main St Bsmt 100, West Hartford, CT 06107-2430 | 2007-02-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.