The Human Growth Center of New Jersey Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

SIO3346 Issued in NJ

Legal business name

THE HUMAN GROWTH CENTER OF NEW JERSEY INC

Practice address

1033 US Highway 46 Ste 106
Clifton, NJ 07013-2448

Phone

(973) 473-0800

Fax

(973) 473-8058

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Konstantin Mouhtis, PH.D.NPI 1770631061

Title

Clinical Director

Phone

(973) 473-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Konstantin Mouhtis, PH.D.

  • Clinical Psychologist
  • Clifton, NJ
  • NPI 1770631061
  NPD (past) Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255464764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46 STE 106",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132448",
            "telephone_number": "973-473-0800",
            "fax_number": "973-473-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 US HIGHWAY 46 STE 106",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132448",
            "telephone_number": "973-473-0800",
            "fax_number": "973-473-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HUMAN GROWTH CENTER OF NEW JERSEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOUHTIS",
        "authorized_official_first_name": "KONSTANTIN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-473-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "SIO3346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "SIO3346",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.