Active NPI
Kelly Chu, PSYD
- Clinical Psychologist
- East Orange, NJ
National Provider Identifier
1194339259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 023807
- Practice address
- 385 Tremont Ave
East Orange, NJ 07018-1023 - Phone
- (973) 676-1000
- NPI assigned
- Sep 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 023807 | NY | Primary |
Addresses
Primary practice location
385 Tremont Ave
East Orange, NJ 07018-1023
Mailing address
82 Prospect St Apt 3
Jersey City, NJ 07307-1868
Phone (732) 925-9677
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599177600000",
"number": "1194339259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 PROSPECT ST APT 3",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073071868",
"telephone_number": "732-925-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 TREMONT AVE",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070181023",
"telephone_number": "973-676-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHU",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-04",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.