Ilana Tannenbaum, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

35SI00470500 Issued in NJ

Practice address

31 S Fullerton Ave
2ND Floor
Montclair, NJ 07042-3455

Phone

(973) 744-4494

NPI assigned

Mar 31, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Novo Psychological Services LLC

  • Psychologist
  • Montclair, NJ
  • NPI 1811388572
  NPD (past)
• Wolf Mehlman Psychological Associates LLC

  • Psychologist
  • Montclair, NJ
  • NPI 1447407903
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1003131269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 BERKELEY AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S FULLERTON AVE",
            "address_2": "2ND FLOOR",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423455",
            "telephone_number": "973-744-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "ILANA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "35SI00470500",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NJ",
            "license": "35SI00470500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Switzer, LCSW
• David George Szmak, PSY.D.
• Khalid Abdelsalam Mohamed Tahir
• Daniel D Tang, M.D.
• Catherine Dorothy Tanis, LCSW
• Jade Sennett Tapia
• Tara Pellegrino LLC
• Jacqueline Tassiello
• Danielle Taylor, PSYD
• Elizabeth Taylor, CD, CBE, LC

• Counseling Psychologist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Counseling Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.