Jennifer Ra, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35SI00453400 Issued in NJ

Practice address

307 Bloomfield Ave Ste 301
Caldwell, NJ 07006-5105

Phone

(973) 524-6501

NPI assigned

Mar 8, 2015

Last updated

Aug 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jennifer Ra LLC

  dba Ra Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Caldwell, NJ
  • NPI 1891303392
  NPD Authorized official

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

{
    "created_epoch": "1425772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1144613654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BLOOMFIELD AVE STE 301",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065105",
            "telephone_number": "973-524-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BLOOMFIELD AVE STE 301",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065105",
            "telephone_number": "973-524-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-08",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00453400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; 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.