Individual provider Active NPI

Marjorie Woodruff, PH.D.

  • Adult Development & Aging Psychologist
  • Somerville, NJ
National Provider Identifier
1316975790
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
35SI00427000 Issued in NJ
Practice address
62 E Main St
Somerville, NJ 08876-2312
Phone
(908) 725-8880
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 35SI00427000 NJ Primary

Addresses

Primary practice location

62 E Main St
Somerville, NJ 08876-2312

Mailing address

25 Clifton Ter
Weehawken, NJ 07086-7019
Phone (201) 558-0708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000155 NJ Practitioner - Clinical Psychologist 4284633348 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00427000NJMDAdult Development & Aging Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Behavioral Health Services PC CurrentSince Jul 1, 2014 Accepting new patients
Vicki Barnett Psy D PC CurrentSince May 2, 2007 Accepting new patients

Locations

525 Monmouth St
Jersey City, NJ 07302
Phone (201) 653-8800

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316975790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CLIFTON TER",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070867019",
            "telephone_number": "201-558-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 E MAIN ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762312",
            "telephone_number": "908-725-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "MARJORIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NJ",
            "license": "35SI00427000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.