Organization Active NPI

Psychological Services of NJ PC

  • Clinical Psychologist
  • Basking Ridge, NJ
National Provider Identifier
1134638828
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00579400 Issued in NJ
Legal business name
PSYCHOLOGICAL SERVICES OF NJ PC
Practice address
233 Mount Airy Rd Ste 100
Basking Ridge, NJ 07920-2338
Phone
(908) 705-4658
NPI assigned
Sep 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Dr. Michele Brennan, PSYDNPI 1144572199
Title
Director
Phone
(908) 705-4658

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 35SI00579400 NJ Primary

Addresses

Primary practice location

233 Mount Airy Rd Ste 100
Basking Ridge, NJ 07920-2338

Mailing address

233 Mount Airy Rd Ste 100
Basking Ridge, NJ 07920-2338
Phone (908) 705-4658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171117001306 NJ Part B Supplier - Clinic/Group Practice 2769748110 Receives reassigned benefits from 6 practitioners
Practice locations: Basking Ridge, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1134638828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 MOUNT AIRY RD STE 100",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202338",
            "telephone_number": "908-705-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 MOUNT AIRY RD STE 100",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202338",
            "telephone_number": "908-705-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-705-4658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00579400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.