| Kristina Hallett, Phd, Abpp. Inc. | |
|
880 Burbank Ave Suffield CT 06078-1459 | |
| (860) 965-1655 | |
| (860) 668-4943 |
| Full Name | Kristina Hallett, Phd, Abpp. Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 880 Burbank Ave, Suffield, Connecticut |
| Authorized Official Name and Position | Kristina Hallett (OWNER) |
| Authorized Official Contact | 8609651655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristina Hallett, Phd, Abpp. Inc. 880 Burbank Ave Suffield CT 06078-1459 Ph: (860) 965-1655 | Kristina Hallett, Phd, Abpp. Inc. 880 Burbank Ave Suffield CT 06078-1459 Ph: (860) 965-1655 |
| NPI Number | 1720511389 |
|---|---|
| Provider Enumeration Date | 04/10/2017 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 6608143441 |
|---|---|
| Medicare Enrollment ID | O20170525001823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720511389 | NPI | - | NPPES |
| 008066110 | Medicaid | CT | |
| W50652 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 002493 (Connecticut) | Primary |
| Provider Name | Kristina M Hallett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841231917 PECOS PAC ID: 6507876455 Enrollment ID: I20060424000057 |
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