Individual provider Active NPI

Jouhaina Razzouk, PSYD

  • Clinical Psychologist
  • Ewing, NJ
National Provider Identifier
1336487586
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00469500 Issued in NJ
Practice address
830 Bear Tavern Rd
Ewing, NJ 08628-1020
Phone
(800) 370-3651
NPI assigned
Jan 23, 2013
Last updated
Jan 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00469500 NJ Primary

Addresses

Primary practice location

830 Bear Tavern Rd
Ewing, NJ 08628-1020

Mailing address

2602 Forest Haven Blvd
Edison, NJ 08817-6334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • 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
I20130213000178 NJ Practitioner - Clinical Psychologist 8224282637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haven Psychotherapy LLCGroup PAC ID 8820497936, 4 clinicians

Practice addresses (Care Compare)

25 Terrell Rd
Lambertville, NJ 08530-3428
Phone (732) 910-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Psychotherapy LLC Clinical CurrentSince Feb 13, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1336487586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 FOREST HAVEN BLVD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088176334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 BEAR TAVERN RD",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281020",
            "telephone_number": "800-370-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZZOUK",
        "first_name": "JOUHAINA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00469500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

Verify at the official NPI Registry.