Individual provider Active NPI

Antoinette Cooper Tate, PHD

  • Psychologist
  • Moorestown, NJ
National Provider Identifier
1417181850
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00544600 Issued in NJ
Practice address
720 E Main St Ste 1a
Moorestown, NJ 08057-3058
Phone
(856) 722-9043
Fax
(856) 727-1715
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00544600 NJ Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

720 E Main St Ste 1a
Moorestown, NJ 08057-3058

Mailing address

720 E Main St Ste 1a
Moorestown, NJ 08057-3058
Phone (856) 722-9043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015002724 NJ Practitioner - Clinical Psychologist 2062764335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temenos Center LLCGroup PAC ID 7416205232, 7 clinicians

Practice addresses (Care Compare)

720 E Main St
Suite 1a
Moorestown, NJ 08057-3058
Phone (856) 722-9043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Temenos Center LLC CurrentSince Sep 1, 2018 Accepting new patients

Locations

720 E Main St
Ste 1A
Moorestown, NJ 08057
Phone (856) 722-9043

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1417181850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E MAIN ST STE 1A",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573058",
            "telephone_number": "856-722-9043",
            "fax_number": "856-727-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E MAIN ST STE 1A",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573058",
            "telephone_number": "856-722-9043",
            "fax_number": "856-727-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "ANTOINETTE",
        "middle_name": "COOPER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00544600",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.