Organization Active NPI

SVR Psychological Services, PC

  • Clinical Psychologist
  • Clifton, NJ
National Provider Identifier
1255738415
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100324600 Issued in NJ
Legal business name
SVR PSYCHOLOGICAL SERVICES, PC
Practice address
777 Passaic Ave
5TH Floor
Clifton, NJ 07012-1804
Phone
(973) 815-0777
NPI assigned
Dec 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Dr. Samuelle Klein-Von Reiche, PAYD
Title
Owner
Phone
99734600099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 35S100324600 NJ Primary

Addresses

Primary practice location

777 Passaic Ave
5TH Floor
Clifton, NJ 07012-1804

Mailing address

777 Passaic Ave
Suite 365
Clifton, NJ 07012-1804
Phone (973) 460-0099

Other identifiers 1

IdentifierTypeStateIssuer
35S100324600OtherNJNJ STATE LICENSE

National Provider Directory

National Provider Directory

Locations

777 Passaic Ave
#365
Clifton, NJ 07012
Phone (973) 460-0099

777 Passaic Ave
Fl 5
Clifton, NJ 07012
Phone (201) 618-3616

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1255738415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 PASSAIC AVE",
            "address_2": "SUITE 365",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121804",
            "telephone_number": "973-460-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PASSAIC AVE",
            "address_2": "5TH FLOOR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121804",
            "telephone_number": "973-815-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVR PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "KLEIN-VON REICHE",
        "authorized_official_first_name": "SAMUELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "99734600099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PAYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100324600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE LICENSE",
            "identifier": "35S100324600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.