Active NPI
Susan A. Grossbard, PSY.D.
- Psychologist
- Wayne, NJ
National Provider Identifier
1164631313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100385300
- Practice address
- 600 Valley Rd
Suite 205
Wayne, NJ 07470-3535 - Phone
- (973) 715-9446
- NPI assigned
- May 22, 2007
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100385300 | NJ | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | 35SI00385300 | NJ | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 35SI00385300 | NJ | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 35SI00385300 | NJ | |
| School Psychologist | 103TS0200X | 35SI00385300 | NJ |
Addresses
Primary practice location
600 Valley Rd
Suite 205
Wayne, NJ 07470-3535
Mailing address
70 Hershey Rd
Wayne, NJ 07470-5536
Phone (973) 715-9446
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100385300 | NJ | MD | Psychologist |
| 35SI00385300 | NJ | MD | Cognitive & Behavioral Psychologist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Wayne, NJ
- NPI 1932431921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265068800000",
"number": "1164631313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 HERSHEY RD",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074705536",
"telephone_number": "973-715-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 VALLEY RD",
"address_2": "SUITE 205",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074703535",
"telephone_number": "973-715-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSBARD",
"first_name": "SUSAN",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2010-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100385300",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NJ",
"license": "35SI00385300",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NJ",
"license": "35SI00385300",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "NJ",
"license": "35SI00385300",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NJ",
"license": "35SI00385300",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.