NPIMap

Organization Active NPI

Farifield Township School

  • Psychologist
  • Bridgeton, NJ
National Provider Identifier
1477956837
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
40611 Issued in NJ
Legal business name
FARIFIELD TOWNSHIP SCHOOL
Practice address
375 Gouldtown Woodruff Rd
Bridgeton, NJ 08302-7242
Phone
(856) 453-1882
Fax
(856) 453-7189
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Mr. Richard Davidson
Title
Ba
Phone
(856) 453-1882

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 40611 NJ Primary
Social Worker 104100000X 538341 NJ
Physical Therapist 225100000X 40QA00518300 NJ
Occupational Therapist 225X00000X 46TR00264300 NJ
Speech-Language Pathologist 235Z00000X 89331 NJ

Addresses

Primary practice location

375 Gouldtown Woodruff Rd
Bridgeton, NJ 08302-7242

Mailing address

375 Gouldtown Woodruff Rd
Bridgeton, NJ 08302-7242
Phone (856) 453-1882

Other identifiers 1

IdentifierTypeStateIssuer
6544908MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Fairfield Township Board of Education2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

375 Gouldtown Woodruff Rd
Bridgeton, NJ 08302
Phone (856) 453-1882

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1477956837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 GOULDTOWN WOODRUFF RD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083027242",
            "telephone_number": "856-453-1882",
            "fax_number": "856-453-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 GOULDTOWN WOODRUFF RD",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083027242",
            "telephone_number": "856-453-1882",
            "fax_number": "856-453-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIFIELD TOWNSHIP SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "BA",
        "authorized_official_telephone_number": "856-453-1882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "40611",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "538341",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00518300",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00264300",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "89331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6544908",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.