Tabula Rasa Psychotherapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TABULA RASA PSYCHOTHERAPY, LLC

Practice address

190 Wiley Ave
Plainfield, NJ 07062-1343

Phone

(973) 637-0375

NPI assigned

Oct 26, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Charice Sumerlin, PSYD, LMFTNPI 1245661420

Title

Lic. Marriage & Family Therapist

Phone

(973) 637-0375

Specialties & licenses 3

Addresses

Practitioners 1

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

• Jennifer Sumerlin, PSYD, MFT

  • Marriage & Family Therapist
  • Morristown, NJ
  • NPI 1245661420
  NPD Authorized official

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1194489161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WILEY AVE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070621343",
            "telephone_number": "973-637-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WILEY AVE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070621343",
            "telephone_number": "973-637-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABULA RASA PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "SUMERLIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "CHARICE",
        "authorized_official_title_or_position": "LIC. MARRIAGE & FAMILY THERAPIST",
        "authorized_official_telephone_number": "973-637-0375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Plainfield, NJ
• Providers in Plainfield, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.