Active NPI
Stephanie Jimenez, PSY.M., M.A.
- School Psychologist
- Piscataway, NJ
National Provider Identifier
1154153898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 01818858
- Practice address
- 671 Hoes LN W
Piscataway, NJ 08854-8021 - Phone
- (732) 235-3289
- NPI assigned
- Aug 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 01818858 | NJ | Primary |
Addresses
Primary practice location
671 Hoes LN W
Piscataway, NJ 08854-8021
Mailing address
671 Hoes LN W
Piscataway, NJ 08854-8021
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01818858 | NJ | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1154153898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "671 HOES LN W",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088548021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "671 HOES LN W",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088548021",
"telephone_number": "732-235-3289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "STEPHANIE",
"credential": "PSY.M., M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NJ",
"license": "01818858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Piscataway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.