Active NPI
Sandra M. Reiken, MSW, PHD
- Clinical Psychologist
- Boonton, NJ
National Provider Identifier
1306926696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35S100282600
- Practice address
- 14 Ashwood TRL
Boonton, NJ 07005-8838 - Phone
- (973) 714-6659
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35S100282600 | NJ | Primary |
Addresses
Primary practice location
14 Ashwood TRL
Boonton, NJ 07005-8838
Mailing address
280 Powerville Rd
Boonton, NJ 07005-9152
Phone (973) 402-4855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2020 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100282600 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1306926696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 POWERVILLE RD",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070059152",
"telephone_number": "973-402-4855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 ASHWOOD TRL",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070058838",
"telephone_number": "973-714-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIKEN",
"first_name": "SANDRA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "MSW, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35S100282600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boonton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.