Elements Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ELEMENTS PSYCHOLOGICAL SERVICES, LLC

Practice address

210 Summit Ave Ste C-2a
Montvale, NJ 07645-1579

Phone

(201) 383-5056

NPI assigned

May 21, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Amelia McCarthyNPI 1205355542

Title

Director

Phone

(201) 383-5056

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica A. McCarthy, PSY.D.

  • Clinical Neuropsychologist
  • Montvale, NJ
  • NPI 1205355542
  Medicare reassignment NPD Authorized official
• Dennis Carlson, LAC

  • Counselor
  • Chatham, NJ
  • NPI 1235017310
  NPD (past)
• Tara Donatiello, LPC, NCC

  • Professional Counselor
  • Rockaway, NJ
  • NPI 1558095547
  NPD (past)

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1447873781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SUMMIT AVE STE C-2A",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451579",
            "telephone_number": "201-383-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SUMMIT AVE STE C-2A",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451579",
            "telephone_number": "201-383-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEMENTS PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "AMELIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-383-5056"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dmitri N. Luke, D.P.M. L.L.C. (Montvale Podiatry)
• Dong Heon Oh DDS PC
• Anupama Doraiswamy, MD
• Ayla H Dunn, CPM
• Mary Elizabeth Dzibela, NTP
• Empire Physical Medicine
• Empowered Pelvic Health LLC
• Empowered Pelvic Therapy LLC
• Enhance Dermatology, PC (Abeles Dermatology Aesthetic & Laser Arts)
• Everas Community Services, Inc.

• Clinical Psychologist in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.