Union Child & Adolescent Psychiatry Center LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

25MA08626200 Issued in NJ

Legal business name

UNION CHILD & ADOLESCENT PSYCHIATRY CENTER LLC

Practice address

33 Upper Overlook Road
210
Summit, NJ 07910

Phone

(908) 598-0390

NPI assigned

Sep 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Indira Shah, MD

Title

MD

Phone

(917) 678-6319

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1245609932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PINEWOOD CRES",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER OVERLOOK ROAD",
            "address_2": "210",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07910",
            "telephone_number": "908-598-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION CHILD & ADOLESCENT PSYCHIATRY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "INDIRA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "917-678-6319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NJ",
            "license": "25MA08626200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Tuli, MA
• Sarah Tyndall, NP-C
• Laura A. Tyson, MSW LCSW LCADC
• Charles M. Udvarnoky
• Spencer Ulrich, PT
• Universal Health Care Navigators
• Adem Ural, DO
• William S Vallario, PHARMACIST
• Marisa Vanbuskirk, APN
• Gwendolyn Vanvolkenburgh, LCSW

• Adolescent and Children Mental Health Clinic/Center in Summit, NJ
• Providers in Summit, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.