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General NPI Number Information
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NPI Number | 1598205395
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Entity Type | Individual
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Provider Name | KEVIN COLWELL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 141 ELM ST
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City | CHESHIRE
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State | CT
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Zip | 06410
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Country | US
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Telephone | 203-232-7956
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Fax | 203-298-6254
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Provider Business Mailing Address
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Address Line | 1393 DIAMOND HILL RD
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City | CHESHIRE
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State | CT
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Zip | 06410-1899
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Country | US
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Telephone | 203-232-7956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3129
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 003129
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 003129
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 003129
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 003129
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License Number State | CT
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