Active NPI
Nicole Ann Waldron, PSY.D.
- Clinical Psychologist
- Bloomfield, NJ
National Provider Identifier
1174610182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00410200
- Practice address
- 348 Franklin St
Third Floor
Bloomfield, NJ 07003-3496 - Phone
- (973) 429-1317
- Fax
- (888) 471-8647
- NPI assigned
- Oct 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00410200 | NJ | Primary |
Addresses
Primary practice location
348 Franklin St
Third Floor
Bloomfield, NJ 07003-3496
Mailing address
348 Franklin St
Third Floor
Bloomfield, NJ 07003-3496
Phone (973) 429-1317
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00410200 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1174610182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "348 FRANKLIN ST",
"address_2": "THIRD FLOOR",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "070033496",
"telephone_number": "973-429-1317",
"fax_number": "888-471-8647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "348 FRANKLIN ST",
"address_2": "THIRD FLOOR",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "070033496",
"telephone_number": "973-429-1317",
"fax_number": "888-471-8647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "NICOLE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00410200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.