NPIMap

Organization Active NPI

Creative Intervention for Mental Health and Chemical Dependency, PC

  • Clinical Psychologist
  • Clifton, NJ
National Provider Identifier
1043360266
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CREATIVE INTERVENTION FOR MENTAL HEALTH AND CHEMICAL DEPENDENCY, PC
Practice address
1149 Bloomfield Ave
Clifton, NJ 07012-2314
Phone
(973) 365-2300
Fax
(973) 365-0868
NPI assigned
Jan 11, 2007
Last updated
Jan 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Dr. Linda Gochfeld, MDNPI 1972650448
Title
Medical Director
Phone
(609) 662-3096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1149 Bloomfield Ave
Clifton, NJ 07012-2314

Mailing address

20 Scotch Road
3Rd Floor
Ewing, NJ 08628-2503
Phone (609) 406-0100

National Provider Directory

National Provider Directory

Locations

1149 Bloomfield Ave
Clifton, NJ 07012
Phone (973) 365-2300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1043360266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SCOTCH ROAD",
            "address_2": "3RD FLOOR",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086282503",
            "telephone_number": "609-406-0100",
            "fax_number": "609-406-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122314",
            "telephone_number": "973-365-2300",
            "fax_number": "973-365-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE INTERVENTION FOR MENTAL HEALTH AND CHEMICAL DEPENDENCY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "GOCHFELD",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-662-3096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.