Individual provider Active NPI

Andrea Lynn Sollitto, ED.D.

  • Psychologist
  • Freehold, NJ
National Provider Identifier
1477568236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35100163500 Issued in NJ
Practice address
94 W Main St
Freehold, NJ 07728-2133
Phone
(732) 780-0347
Fax
(732) 780-0346
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35100163500 NJ Primary

Addresses

Primary practice location

94 W Main St
Freehold, NJ 07728-2133

Mailing address

94 W Main St
Freehold, NJ 07728-2133
Phone (732) 780-0347

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
I20050616000024 NJ Practitioner - Clinical Psychologist 1052355492 Practice locations: Freehold, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

94 W Main St
Freehold, NJ 07728-2133
Phone (732) 780-0347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35100163500NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychological Services,LLC Past Accepting new patients

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477568236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282133",
            "telephone_number": "732-780-0347",
            "fax_number": "732-780-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282133",
            "telephone_number": "732-780-0347",
            "fax_number": "732-780-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLITTO",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35100163500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.