Clinical Specialist, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CLINICAL SPECIALIST, LLC

Practice address

1420 S New Rd
Pleasantville, NJ 08232-3728

Phone

(609) 200-5117

Fax

(609) 939-3671

NPI assigned

Feb 14, 2019

Last updated

May 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ellen D Doyle, NPNPI 1174774061

Title

Ownwer/Provider

Phone

(609) 200-5117

Specialties & licenses 5

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21497/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ellen D Doyle, APN,PMHNP-C,FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Pleasantville, NJ
  • NPI 1174774061
  Medicare reassignment Authorized official
• Kayla Lynne Stone

  • Addiction (Substance Use Disorder) Counselor
  • Pleasantville, NJ
  • NPI 1770106718
  NPD

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1366908303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 S NEW RD",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082323728",
            "telephone_number": "609-200-5117",
            "fax_number": "609-939-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S NEW RD",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082323728",
            "telephone_number": "609-200-5117",
            "fax_number": "609-939-3671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Sanderling Ln",
            "address_purpose": "LOCATION",
            "city": "Pleasantville",
            "state": "NJ",
            "postal_code": "082322902",
            "country_code": "US",
            "telephone_number": "609-568-0305",
            "fax_number": "609-939-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLINICAL SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2022-05-20",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNWER/PROVIDER",
        "authorized_official_telephone_number": "609-200-5117",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "601369570",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "2105250",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0673218",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACONHORIZON",
            "identifier": "1029561",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rafat S Choudhry, MD
• Chinasa Chudi-Attah
• City of Pleasantville (Pleasantville EMS)
• Jancy Civichan
• Michelle Anna Cleary
• Jacob Franklin Cogen, MD
• Robin A Cohen-Feehan, LMT
• Arthur Michael Cohen, DC
• Faye Colon
• Amy Czenis, APN

• Psychiatric/Mental Health Nurse Practitioner in Pleasantville, NJ
• Providers in Pleasantville, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.