Kathleen McNulty PHD, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

KATHLEEN MCNULTY PHD, LLC

Practice address

24 Godwin Ave Ste 1-6
Midland Park, NJ 07432-1927

Phone

(201) 299-4001

Fax

(941) 916-9902

NPI assigned

Jun 5, 2022

Organization subpart

No

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

Authorized official

Name

Kathleen McNulty, PHDNPI 1770619066

Title

Owner

Phone

(551) 580-0571

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Kathleen McNulty, L.C.S.W., PHD

  • Clinical Psychologist
  • Midland Park, NJ
  • NPI 1770619066
  Medicare reassignment NPD Authorized official
• Lauren Maynard

  • Marriage & Family Therapist
  • Montclair, NJ
  • NPI 1669353215
  NPD (past)

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

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1285363432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GODWIN AVE STE 1-6",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321927",
            "telephone_number": "201-299-4001",
            "fax_number": "941-916-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GODWIN AVE STE 1-6",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321927",
            "telephone_number": "201-299-4001",
            "fax_number": "941-916-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN MCNULTY PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-05",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "551-580-0571",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHD",
            "identifier": "103T00000X",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drkmcnulty@hushmail.com",
            "affiliation": "N",
            "address_1": "24 Godwin Ave Ste 1-6",
            "city": "Midland Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074321927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "24 Godwin Ave Ste 1-6",
            "city": "Midland Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074321927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allison Johnson, PH.D., LPC
• Joseph a. Demarco, MD, PC
• Jr Talk Therapy LLC
• Yuri N/a Jung
• Erika D Kao, LCSW
• Harry Katz, MD
• Alexis Kawalec, OTR/L
• Michelle Kearney, LCSW
• Keith Seidenberg, MD LLC
• Dylan Kelczewski, SLP

• Psychologist in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.