Active NPI
Salma Habib Khshaiboon, PHD
- Counseling Psychologist
- West Orange, NJ
National Provider Identifier
1063871895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PS02223
- Practice address
- 623 Eagle Rock Ave
Ste 1
West Orange, NJ 07052-2948 - Phone
- (973) 790-9222
- NPI assigned
- Feb 22, 2016
- Last updated
- Nov 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Counseling Psychologist | 103TC1900X | PS02223 | RI | Primary |
Addresses
Primary practice location
623 Eagle Rock Ave
Ste 1
West Orange, NJ 07052-2948
Mailing address
PO Box 433
West Orange, NJ 07052-0433
Phone (347) 450-5320
Other practice location 1
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-2128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS02223 | RI | MD | Counseling Psychologist |
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.
-
- Psychologist
- West Orange, NJ
- NPI 1780140012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1063871895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 433",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070520433",
"telephone_number": "347-450-5320",
"fax_number": "973-860-0889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 EAGLE ROCK AVE",
"address_2": "STE 1",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522948",
"telephone_number": "973-790-9222"
}
],
"practiceLocations": [
{
"address_1": "593 Eddy St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029034923",
"country_code": "US",
"telephone_number": "401-444-2128",
"fax_number": "401-444-8836",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHSHAIBOON",
"first_name": "SALMA",
"middle_name": "HABIB",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-22",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "RI",
"license": "PS02223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.