Individual provider Active NPI

Linda Terry Mack, PSY.D.

  • Clinical Psychologist
  • Hackensack, NJ
National Provider Identifier
1063523041
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00308900 Issued in NJ
Practice address
83 Summit Ave
Hackensack, NJ 07601-1262
Phone
(201) 488-6678
Fax
(201) 224-0599
NPI assigned
Aug 31, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00308900 NJ
Clinical Psychologist 103TC0700X 35SI00308900 NJ Primary

Addresses

Primary practice location

83 Summit Ave
Hackensack, NJ 07601-1262

Mailing address

83 Summit Ave
Hackensack, NJ 07601-1262
Phone (201) 488-6678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140304000534 NJ Practitioner - Clinical Psychologist 2961631866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3640 Valley Rd
Liberty Corner, NJ 07938-0132
Phone (908) 484-7354

PO Box
Suite 132
Liberty Corner, NJ 07938-0132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00308900NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Group, LLC Clinical CurrentSince Nov 9, 2013 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1063523041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011262",
            "telephone_number": "201-488-6678",
            "fax_number": "201-224-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011262",
            "telephone_number": "201-488-6678",
            "fax_number": "201-224-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LINDA",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00308900",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00308900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.