Jennifer Keenan Smith, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

017988-1 Issued in NY

Practice address

151 Knollcroft Rd
Lyons, NJ 07939-5001

Phone

(908) 647-0180

Fax

(908) 604-5251

NPI assigned

Jun 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Elizabeth Keenan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1497981047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "KEENAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017988-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KEENAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Ann Sheppard, DMD
• Rose Ann Shovlin, AU.D, CCC-A, FAAA
• Loveleen Sidhu, MD
• Christopher Small, PHARMD
• Irmhild Wrede Smith, RN
• Melanie Snider, CTRS
• Olga Bienvenida Soto-Moise, MD
• Lauren St Hill
• Melissa Rose Stellitano, DMD
• Susan K Strahs, RD,CDE

• Psychologist in Lyons, NJ
• Providers in Lyons, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.