Creative Reminiscence & Psychotherapy, PC

Key facts

NPI: 1477510642
Entity type: Organization (NPI type 2)
Primary specialty: Point of Service 305S00000X
License: 35SI00306500 (NJ)
Legal business name: CREATIVE REMINISCENCE & PSYCHOTHERAPY, PC
Practice address: 3 S Main St
Allentown, NJ 08501-1615
Phone: (609) 443-3828
NPI assigned: Apr 28, 2006
Organization subpart: No

Authorized official

Name: Dr. Laura Tahir, PH.D. NPI 1508005935
Title: President
Phone: (609) 443-3828

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Laura Tahir, PH.D. Clinical Psychologist · Allentown, NJ · NPI 1508005935

Medicare reassignment NPD Authorized official NJ

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NJ

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20090430000070	NJ	Part B Supplier - Clinic/Group Practice	0345206454	Receives reassigned benefits from 1 practitioner Practice locations: Allentown, NJ

National Provider Directory

Locations

30 Broad St
Ste 1443
New York, NY 10004
Phone (917) 273-4544

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Point of Service	305S00000X	35SI00306500	NJ	Yes

Addresses

Primary practice location

3 S Main St
Allentown, NJ 08501-1615

Mailing address

41 Geraldine Rd
East Windsor, NJ 08520-2631
Phone (609) 443-3828

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 6, 2009.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1477510642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GERALDINE RD",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202631",
            "telephone_number": "609-443-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S MAIN ST",
            "city": "ALLENTOWN",
            "state": "NJ",
            "postal_code": "085011615",
            "telephone_number": "609-443-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE REMINISCENCE & PSYCHOTHERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "TAHIR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-443-3828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NJ",
            "license": "35SI00306500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, NJ

All providers in Allentown, NJ · Point of Service in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.