Richard Selznick, PH.D

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

35SI00239000 Issued in NJ

Practice address

110 Marter Ave Ste 506
Moorestown, NJ 08057

Phone

(856) 763-4900

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• CMC Psychiatric Associates, PC

  • Psychiatry Physician
  • Camden, NJ
  • NPI 1982646634
  NPD
• Cooper Pediatric Specialists, PC

  • Pediatrics Physician
  • Camden, NJ
  • NPI 1306867585
  NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1013097138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MARTER AVE STE 506",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-763-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Main St",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434606",
            "country_code": "US",
            "telephone_number": "856-751-9339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6400 Main St",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434606",
            "country_code": "US",
            "telephone_number": "856-751-9339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELZNICK",
        "first_name": "RICHARD",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "S102390",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00239000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET, INC",
            "identifier": "3K5451",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "41023",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2030815",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "26129",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6859801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "91193",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2704835",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giuseppina Scottodicarlo
• Raquel Maria Screnci, PTA
• Avni Segal, M.D.
• Shaun Segal, RD
• Susan Seifried, RN
• Serenity Counseling, LLC
• Serenity Health of NJ LLC
• Deepa S Shah, D.O.
• Kristina Chandan Shah, MD
• Nishita Shah, PHARMD

• Clinical Child & Adolescent Psychologist in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Clinical Child & Adolescent Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.