Active NPI
Luciene (Lucy) Sant'Anna Takagi, PSY.D.
- Clinical Psychologist
- Cedar Grove, NJ
National Provider Identifier
1346508264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4936
- Practice address
- 882 Pompton Ave Ste A1
Cedar Grove, NJ 07009-1256 - Phone
- (973) 239-0852
- Fax
- (973) 239-2597
- NPI assigned
- Apr 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4936 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 19014-1 | NY |
Addresses
Primary practice location
882 Pompton Ave Ste A1
Cedar Grove, NJ 07009-1256
Mailing address
882 Pompton Ave Ste A1
Cedar Grove, NJ 07009-1256
Phone (973) 239-0852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 20, 2021 through Sep 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4936 | NJ | MD | Clinical Psychologist |
| 19014-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335571200000",
"number": "1346508264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "882 POMPTON AVE STE A1",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091256",
"telephone_number": "973-239-0852",
"fax_number": "973-239-2597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "882 POMPTON AVE STE A1",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091256",
"telephone_number": "973-239-0852",
"fax_number": "973-239-2597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKAGI",
"first_name": "LUCIENE (LUCY)",
"middle_name": "SANT'ANNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-28",
"last_updated": "2012-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "4936",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "19014-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Grove, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2012; 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.