Healthcare Provider Details

I. General information

NPI: 1265283980
Provider Name (Legal Business Name): NORA RAO-MCKENNEDY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 GAYLORD FARM RD
WALLINGFORD CT
06492-2899
US

IV. Provider business mailing address

50 GAYLORD FARM RD
WALLINGFORD CT
06492-2899
US

V. Phone/Fax

Practice location:
  • Phone: 203-284-2800
  • Fax:
Mailing address:
  • Phone: 203-284-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5136
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10000972
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: