Individual provider Active NPI

Candice Nattland, PSY.D.

  • Psychologist
  • Verona, NJ
National Provider Identifier
1114947561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2103 Issued in NJ
Practice address
25 Grove Ave
Verona, NJ 07044-1631
Phone
(973) 783-2110
Fax
(908) 475-3328
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2103 NJ Primary

Addresses

Primary practice location

25 Grove Ave
Verona, NJ 07044-1631

Mailing address

25 Grove Ave
Verona, NJ 07044-1631
Phone (973) 783-2110

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
I20050624000967 NJ Practitioner - Clinical Psychologist 4789629106 Practice locations: Columbia, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

173 Route 46
Columbia, NJ 07832-2039
Phone (973) 783-2110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2103NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114947561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GROVE AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441631",
            "telephone_number": "973-783-2110",
            "fax_number": "908-475-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GROVE AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441631",
            "telephone_number": "973-783-2110",
            "fax_number": "908-475-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATTLAND",
        "first_name": "CANDICE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "2103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

Verify at the official NPI Registry.