Individual provider Active NPI

Naomi Bauman, PSYD

  • Clinical Child & Adolescent Psychologist
  • Fair Lawn, NJ
National Provider Identifier
1114393824
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
35SI00643400 Issued in NJ
Practice address
12-33 Scribner Rd
Fair Lawn, NJ 07410-4243
Phone
(203) 489-6641
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 023888 NY
Clinical Child & Adolescent Psychologist 103TC2200X 35SI00643400 NJ Primary

Addresses

Primary practice location

12-33 Scribner Rd
Fair Lawn, NJ 07410-4243

Mailing address

12-33 Scribner Rd
Fair Lawn, NJ 07410-4243
Phone (203) 489-6641

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35SI00643400NJMDClinical Child & Adolescent Psychologist
023888NYMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1114393824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-33 SCRIBNER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104243",
            "telephone_number": "203-489-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-33 SCRIBNER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104243",
            "telephone_number": "203-489-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "NAOMI",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "023888",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00643400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.