Active NPI
Nicole Liedike
- Clinical Neuropsychologist
- Paramus, NJ
National Provider Identifier
1508669987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- Practice address
- 95 N State RT 17 Ste 100
Paramus, NJ 07652-2648 - Phone
- (551) 368-0304
- NPI assigned
- Mar 31, 2025
- 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 Neuropsychologist | 103G00000X | Primary |
Addresses
Primary practice location
95 N State RT 17 Ste 100
Paramus, NJ 07652-2648
Mailing address
10346 Park Meadows Dr Apt 2122
Lone Tree, CO 80124-6873
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1508669987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10346 PARK MEADOWS DR APT 2122",
"city": "LONE TREE",
"state": "CO",
"postal_code": "801246873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 N STATE RT 17 STE 100",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076522648",
"telephone_number": "551-368-0304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEDIKE",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-31",
"last_updated": "2025-03-31",
"certification_date": "2025-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.