Individual provider Active NPI

Amy L Altenhaus, PH.D

  • Clinical Psychologist
  • Freehold, NJ
National Provider Identifier
1063564581
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5860 Issued in NY
Practice address
80 E Main St
Freehold, NJ 07728-2223
Phone
(732) 780-6644
Fax
(732) 845-1184
NPI assigned
Jan 17, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1479 NJ
Clinical Psychologist 103TC0700X 5860 NY Primary
Forensic Psychologist 103TF0200X 5860 NY
Forensic Psychologist 103TF0200X 1479 NJ

Addresses

Primary practice location

80 E Main St
Freehold, NJ 07728-2223

Mailing address

80 E Main St
Freehold, NJ 07728-2223
Phone (732) 780-6644

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
I20180424000025 NJ Practitioner - Clinical Psychologist 6507014156 Practice locations: Freehold, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 E Main St
Freehold, NJ 07728-2223
Phone (732) 780-6644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1479NJMDForensic Psychologist
5860NYMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1063564581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282223",
            "telephone_number": "732-780-6644",
            "fax_number": "732-845-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282223",
            "telephone_number": "732-780-6644",
            "fax_number": "732-845-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENHAUS",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "1479",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "5860",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "5860",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NJ",
            "license": "1479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.