Active NPI
Melissa Ardolino
- Clinical Psychologist
- Cliffside Park, NJ
National Provider Identifier
1376114439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00655700
- Practice address
- 377 Highland Ave
Cliffside Park, NJ 07010-2710 - Phone
- (848) 757-5632
- NPI assigned
- Jul 8, 2021
- 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 | 024169 | NY | |
| Clinical Psychologist | 103TC0700X | 35SI00655700 | NJ | Primary |
Addresses
Primary practice location
377 Highland Ave
Cliffside Park, NJ 07010-2710
Mailing address
377 Highland Ave
Cliffside Park, NJ 07010-2710
Phone (848) 757-5632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2021 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00655700 | NJ | MD | Clinical Psychologist |
| 024169 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1376114439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 HIGHLAND AVE",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070102710",
"telephone_number": "848-757-5632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 HIGHLAND AVE",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070102710",
"telephone_number": "848-757-5632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARDOLINO",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-08",
"last_updated": "2025-02-17",
"certification_date": "2025-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024169",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00655700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cliffside Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.