DR. ELIZABETH A MONGILLO-HERMAN (NPI# 1700017829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700017829 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH A MONGILLO-HERMAN |
| Other Name | DR. ELIZABETH A MONGILLO |
| Credential | PH.D. |
| Practice Address |
784 Farmington Ave West Hartford CT 06119-1619 |
| Practice Telephone | 8605234450 |
| Practice Fax Number | 8605239537 |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2014-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
003111 | CT | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
9381 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008045664 | 05 |
| Street Address |
784 FARMINGTON AVE |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06119-1619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447242037 | Ellen Diane Thomas | Social Worker | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2005-08-18 |
| 1376073700 | Michelle Theresa Kinsella | Counselor | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2017-06-18 |
| 1801132857 | Katie Bassoli | Social Worker | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2012-12-19 |
| 1639473960 | Tracey Anne Robinson | Counselor | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2010-12-30 |
| 1669774352 | Janna Marie Phillips | Counselor | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2010-12-01 |
| 1205159811 | Elizabeth Dawn Houghton | Psychologist | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2010-03-10 |
| 1548592124 | Amy Jacqueline Hunter | Counselor | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2010-02-05 |
| 1710009360 | Women's Center for Psychotherapy,llc | Social Worker | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2007-04-04 |
| 1508942426 | Maryam Jernigan | Psychologist | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2006-10-31 |
| 1992899520 | Beth Michelle Juliano | Social Worker | 784 Farmington Ave, West Hartford, CT 06119-1619 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063957389 | Hannah Aliberti | Behavioral Analyst | 792 Farmington Ave, West Hartford, CT 06119 | 2016-12-21 |
| 1255752945 | Ctuc01 | Clinic/Center | 1030 Boulevard, West Hartford, CT 06119 | 2013-12-23 |
| 1962757088 | Arman Samad-zadeh | Dentist | 836 Farmington Ave Ste 115, West Hartford, CT 06119 | 2012-07-15 |
| 1356606123 | East West Obgyn | Obstetrics & Gynecology | 836 Farmington Ave. S. 211, West Hartford, CT 06119 | 2012-07-09 |
| 1285901314 | Onyeijen Mgbejume | Pharmacist | 674 Famington Avenue, West Hartford, CT 06119 | 2011-11-17 |
| 1134403553 | Cornelia F Sharrow | Social Worker | 17 South Highland St, West Hartford, CT 06119 | 2011-10-04 |
| 1952613218 | Lauren B Kopyt | Pediatrics | 785 Farmington Avenue, West Hartford, CT 06119 | 2010-07-02 |
| 1043542657 | Leticia Jacquet | Physical Therapist | 1022 Boulevard, #274, West Hartford, CT 06119 | 2010-02-06 |
| 1003051467 | Emily Bevelaqua Pellegrino | Music Therapist | 72 Maplewood Ave, West Hartford, CT 06119 | 2008-12-12 |
| 1124233473 | Theresa M Johnson | Counselor | 361 Park Rd, 3rd Fl, West Hurtford, CT 06119 | 2007-05-11 |
| Find all providers in zip 06119 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376004481 | Frank J Stoll, Ph.d., LLC | Psychologist | 18 N Main St Fl 3, West Hartford, CT 06107-1970 | 2019-03-29 |
| 1053804575 | Daniel James Martin | Psychologist | 19 Linwold Dr, West Hartford, CT 06107-1237 | 2018-06-09 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1669856555 | Noah Joseph Bluestone | Psychologist | 68 Soutth Main St, Suite 202, West Hartford, CT 06117 | 2015-07-10 |
| 1417200825 | Nicole Reilly Hill | Psychologist | 998 Farmington Ave Ste 109, West Hartford, CT 06107-2184 | 2012-10-23 |
| 1437454717 | Jacqueline Guajardo | Psychologist | 73 Foxridge Rd, West Hartford, CT 06107-3625 | 2011-01-19 |
| 1205140803 | Jason Alan Gockel | Psychologist | 41 S Main St Ste 7, West Hartford, CT 06107-2448 | 2010-08-06 |
| 1225341696 | Ira Potashner | Psychologist | 61 S Main St Ste 209, West Hartford, CT 06107-2403 | 2010-07-14 |
| 1730391830 | Jessica A Mitchell-corsino | Psychologist | 45 S Main St Ste 303, West Hartford, CT 06107-2402 | 2007-05-03 |
| 1457579583 | Kathy A Mccloskey | Psychologist | 200 Bloomfield Avenue, University of Hartford, West Hartford, CT 06117 | 2007-04-23 |
| Find all providers in WEST HARTFORD | ||||
| City | WEST HARTFORD |
| Zip Code | 06119 |
Please comment or provide details below to improve the information on DR. ELIZABETH A MONGILLO-HERMAN.
| 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.