Active NPI
Nicole Rebecca Amoyal-Pensak, PH.D.
- Clinical Psychologist
- Red Bank, NJ
National Provider Identifier
1487094959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00568900
- Practice address
- 210 Broad St
Red Bank, NJ 07701-2060 - Phone
- (609) 283-2056
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00568900 | NJ | Primary |
Addresses
Primary practice location
210 Broad St
Red Bank, NJ 07701-2060
Mailing address
145 Monmouth St
Red Bank, NJ 07701-1237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487094959 | Other | NJ | OUT OF NETWORK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1487094959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 MONMOUTH ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077011237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 BROAD ST",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077012060",
"telephone_number": "609-283-2056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMOYAL-PENSAK",
"first_name": "NICOLE",
"middle_name": "REBECCA",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00568900",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OUT OF NETWORK",
"identifier": "1487094959",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bank, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.