Alison Stothard O'Connor, PSYD, BCBA
Individual provider Active NPI Clinical Psychologist · Lakewood, NJ
NPI 1366736233 · NPPES record last updated Mar 1, 2021
Key facts
- NPI
- 1366736233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 35SI00632000 (NJ)
- Practice address
- 815 Cedarbridge Ave
Lakewood, NJ 08701-4933 - Phone
- (732) 363-3335
- NPI assigned
- Jun 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Shore Psychological Healthcare LLC
Practice addresses (Care Compare)
220 Jack Martin Blvd
E2
Brick, NJ 08724-7772
Phone (732) 920-3434
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210416000307 | NJ | Practitioner - Clinical Psychologist | 6709294531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00632000 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shore Psychological Healthcare LLC | Clinical | Current |
Accepting new patients |
Locations
220 Jack Martin Blvd
#E2
Brick, NJ 08724
220 Jack Martin Blvd
Ste E2
Brick, NJ 08724
Phone (732) 905-5600
1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00632000 | NJ | Yes |
Addresses
Primary practice location
815 Cedarbridge Ave
Lakewood, NJ 08701-4933
Mailing address
614 Second Ave # 6
Asbury Park, NJ 07712-5952
Phone (201) 214-7532
Other practice location 1
614 Second Ave # 6
Asbury Park, NJ 07712-5952
Phone (201) 214-7532
Other providers in Lakewood, NJ
- Malka J Nussbaum
- Nutrition and Health Resource
- Nutrition With Mindy LLC
- Beatrice O'Brien
- Ornela O'Callahan
- Oasis Habilitation LLC
- Brenda Oberlander
- Cheryl Obrien
- Sara S Obstfeld
- Alana Obuhovs
All providers in Lakewood, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.