Active NPI
Tina M. Sherry, PSY.D.
- Clinical Psychologist
- Wyckoff, NJ
National Provider Identifier
1497802813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4344
- Practice address
- 239 Madison Ave
Wyckoff, NJ 07481-1948 - Phone
- (201) 669-1369
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 4344 | NJ | Primary |
Addresses
Primary practice location
239 Madison Ave
Wyckoff, NJ 07481-1948
Mailing address
239 Madison Ave
Wyckoff, NJ 07481-1948
Phone (201) 669-1369
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 12, 2026 through Mar 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4344 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1497802813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 MADISON AVE",
"city": "WYCKOFF",
"state": "NJ",
"postal_code": "074811948",
"telephone_number": "201-669-1369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 MADISON AVE",
"city": "WYCKOFF",
"state": "NJ",
"postal_code": "074811948",
"telephone_number": "201-669-1369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRY",
"first_name": "TINA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "4344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyckoff, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.