Henry Srednicki, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

03509 Issued in NJ

Practice address

543 Valley Rd
Suite 6
Upper Montclair, NJ 07043-1881

Phone

(973) 744-9130

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Upper Montclair Psychological Associates, LLC

  • Clinical Psychologist
  • Upper Montclair, NJ
  • NPI 1770658569
  Medicare reassignment NPD Authorized official
• Full Heart Recovery, LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Upper Montclair, NJ
  • NPI 1912397704
  NPD (past) Authorized official

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1255445326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 RELDYES AVE",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051326",
            "telephone_number": "973-744-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 VALLEY RD",
            "address_2": "SUITE 6",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431881",
            "telephone_number": "973-744-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SREDNICKI",
        "first_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "03509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Ellen Selinske, ED.D., LCSW. LP
• Patricia Signorello, D.C.
• Elizabeth Somma, LPC, LPAT, ATR-BC
• Mitchell S Soroka, DC
• Danielle Marie Spera, MS, LAC
• David Patrick St.Ledger, D.D.S.
• David Steinke, PHD
• Stellar Counseling Services
• Betsy Stephens, LSW
• Michaelle Sullivan

• Psychologist in Upper Montclair, NJ
• Providers in Upper Montclair, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.