NPIMap

Organization Active NPI

Comprehensive Psychology System PC

Doing business as Lifespan

  • Psychologist
  • Tinton Falls, NJ
National Provider Identifier
1376663096
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3SS100151900 Issued in NJ
Legal business name
COMPREHENSIVE PSYCHOLOGY SYSTEM PC
Doing business as
Lifespan
Practice address
4000 State Route 66 Ste 331
Tinton Falls, NJ 07753-7300
Phone
(732) 988-4431
Fax
(732) 988-7123
NPI assigned
Mar 29, 2007
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Anita Catherine Watkins-Sica
Title
Administrator
Phone
(732) 988-3441

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NJ
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Psychologist 103T00000X 3SS100151900 NJ Primary
Rehabilitation Psychologist 103TR0400X NJ
Rehabilitation Psychologist 103TR0400X NU

Addresses

Primary practice location

4000 State Route 66 Ste 331
Tinton Falls, NJ 07753-7300

Mailing address

4000 Route 66 Ste 331
Tinton Falls, NJ 07753-7300
Phone (732) 988-3441

Other names 1

  • Lifespan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110307000964 NJ Part B Supplier - Clinic/Group Practice 3577745926 Receives reassigned benefits from 5 practitioners
Practice locations: Tinton Falls, NJ

National Provider Directory

National Provider Directory

Locations

1255 Route 70
Ste 25S
Lakewood, NJ 08701
Phone (732) 961-9701

2100 State Route 33
Ste 10
Neptune, NJ 07753

2100 State Route 33
Ste 910
Neptune City, NJ 07753
Phone (732) 988-3441

4000 State Route 66
Ste 331
Tinton Falls, NJ 07753
Phone (732) 922-0634

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1376663096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 ROUTE 66 STE 331",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537300",
            "telephone_number": "732-988-3441",
            "fax_number": "732-988-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 STATE ROUTE 66 STE 331",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537300",
            "telephone_number": "732-988-4431",
            "fax_number": "732-988-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PSYCHOLOGY SYSTEM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "WATKINS-SICA",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-988-3441"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "3SS100151900",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifespan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinton Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.