Anissa L Moody, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

TP# 093-997 Issued in NJ

Practice address

703 Blue Spring Rd
Princeton, NJ 08540-1636

Phone

(646) 546-0835

NPI assigned

Aug 14, 2009

Last updated

Oct 7, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1386876977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 HERRONTOWN RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401901",
            "telephone_number": "646-546-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 BLUE SPRING RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401636",
            "telephone_number": "646-546-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ANISSA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "TP# 093-997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "TP# 093-997",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.