NPIMap

Organization Active NPI

Activity & Human Performance Center, LLC

  • Psychologist
  • West Orange, NJ
National Provider Identifier
1174857544
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2138 Issued in NJ
Legal business name
ACTIVITY & HUMAN PERFORMANCE CENTER, LLC
Practice address
89 Lapis Cir
West Orange, NJ 07052-2154
Phone
(973) 325-3131
Fax
(973) 325-3150
NPI assigned
Oct 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Authorized official

Name
Mark Harold Seglin, PH.D.NPI 1184754632
Title
President/Licensed Psychologist
Phone
(973) 325-3131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 2138 NJ Primary
Health Maintenance Organization 302R00000X 2138 NJ

Addresses

Primary practice location

89 Lapis Cir
West Orange, NJ 07052-2154

Mailing address

89 Lapis Cir
West Orange, NJ 07052-2154
Phone (973) 325-3131

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1174857544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 LAPIS CIR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522154",
            "telephone_number": "973-325-3131",
            "fax_number": "973-325-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 LAPIS CIR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522154",
            "telephone_number": "973-325-3131",
            "fax_number": "973-325-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVITY & HUMAN PERFORMANCE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "SEGLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "973-325-3131",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "2138",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "2138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.