Active NPI
Jenise Lum, PHD
- Clinical Psychologist
- Brick, NJ
National Provider Identifier
1164057923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00623100
- Practice address
- 1683 Route 88 W
Brick, NJ 08724-3072 - Phone
- (732) 840-5266
- NPI assigned
- Mar 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | |||
| Clinical Psychologist | 103TC0700X | 35SI00623100 | NJ | Primary |
Addresses
Primary practice location
1683 Route 88 W
Brick, NJ 08724-3072
Mailing address
1683 Route 88 W
Brick, NJ 08724-3072
Phone (732) 840-5266
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1164057923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1683 ROUTE 88 W",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243072",
"telephone_number": "732-840-5266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1683 ROUTE 88 W",
"city": "BRICK",
"state": "NJ",
"postal_code": "087243072",
"telephone_number": "732-840-5266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "JENISE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-11",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00623100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.