Charles P Waitz PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00109300 Issued in NJ

Legal business name

CHARLES P WAITZ PHD

Practice address

639 Stokes Rd
Suite 203
Medford, NJ 08055-3003

Phone

(609) 953-1222

Fax

(609) 714-0095

NPI assigned

Jun 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles P Waitz, PHD

Title

Clinical Psychologist Owner

Phone

(609) 953-1222

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Rosemarie Cataldo

  • Cognitive & Behavioral Psychologist
  • Princeton, NJ
  • NPI 1417070913

  Clinical

  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497950422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 STOKES RD",
            "address_2": "SUITE 203",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080553003",
            "telephone_number": "609-953-1222",
            "fax_number": "609-714-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 STOKES RD",
            "address_2": "SUITE 203",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080553003",
            "telephone_number": "609-953-1222",
            "fax_number": "609-714-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES P WAITZ PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAITZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST OWNER",
        "authorized_official_telephone_number": "609-953-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00109300",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS002060L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Medford, NJ
• Providers in Medford, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.