Active NPI
Alan Berlin, PSYD
- Clinical Psychologist
- Passaic, NJ
National Provider Identifier
1003076241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00626800
- Practice address
- 34 Ridge Ave
Passaic, NJ 07055-2419 - Phone
- (973) 563-8010
- NPI assigned
- Jun 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00626800 | NJ | Primary |
Addresses
Primary practice location
34 Ridge Ave
Passaic, NJ 07055-2419
Mailing address
34 Ridge Ave
Passaic, NJ 07055-2419
Phone (973) 563-8010
Other practice location 1
859 Willard St
Ste 430
Quincy, MA 02169-7482
Phone (617) 847-1950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00626800 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Mental Health Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Quincy, MA
- NPI 1770528317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589414400000",
"number": "1003076241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 RIDGE AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070552419",
"telephone_number": "973-563-8010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 RIDGE AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070552419",
"telephone_number": "973-563-8010"
}
],
"practiceLocations": [
{
"address_1": "859 Willard St",
"address_2": "Ste 430",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "MA",
"postal_code": "021697482",
"country_code": "US",
"telephone_number": "617-847-1950",
"fax_number": "617-774-1490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERLIN",
"first_name": "ALAN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00626800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.