Organization Active NPI

John T Miele, PHD LLC

  • Clinical Psychologist
  • Livingston, NJ
National Provider Identifier
1083907901
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JOHN T MIELE, PHD LLC
Practice address
301 S Livingston Ave
Suite 202 (Acap)
Livingston, NJ 07039-3932
Phone
(973) 464-9639
NPI assigned
May 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
John MieleNPI 1821217340
Title
Clinical Psychologist
Phone
(973) 464-9639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

301 S Livingston Ave
Suite 202 (Acap)
Livingston, NJ 07039-3932

Mailing address

112 Dulles Drive
Dumont, NJ 07628-3620

Other identifiers 1

IdentifierTypeStateIssuer
03288406MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
John T Miele PHD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

301 S Livingston Ave
Ste 202
Livingston, NJ 07039
Phone (201) 788-7538

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1083907901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 DULLES DRIVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076283620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S LIVINGSTON AVE",
            "address_2": "SUITE 202 (ACAP)",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393932",
            "telephone_number": "973-464-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN T MIELE, PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "MIELE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "973-464-9639"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03288406",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.