Individual provider Active NPI

Jacob Stier, PSY.D.

  • Psychologist
  • Evesham, NJ
National Provider Identifier
1396497079
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
223-005 Issued in NJ
Practice address
2003 Lincoln Dr W
Evesham, NJ 08053-1529
Phone
(856) 886-8839
NPI assigned
Jan 24, 2022
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 223-005 NJ Primary

Addresses

Primary practice location

2003 Lincoln Dr W
Evesham, NJ 08053-1529

Mailing address

1638 Sunrise Rd
Berlin, NJ 08009-1568
Phone (908) 334-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
223-005NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1396497079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 SUNRISE RD",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091568",
            "telephone_number": "908-334-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 LINCOLN DR W",
            "city": "EVESHAM",
            "state": "NJ",
            "postal_code": "080531529",
            "telephone_number": "856-886-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIER",
        "first_name": "JACOB",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "223-005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evesham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.