Individual provider Active NPI

Pamela Elizabeth Hall, PSYD

  • Clinical Psychologist
  • Summit, NJ
National Provider Identifier
1548321623
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
NJPSYCHOLOGIST2126 Issued in NJ
Practice address
10-12 Kent Place Boulevard
Summit, NJ 07901
Phone
(908) 277-2383
NPI assigned
Dec 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NJPSYCHOLOGIST2126 NJ Primary

Addresses

Primary practice location

10-12 Kent Place Boulevard
Summit, NJ 07901

Mailing address

10-12 Kent Place Blvd
Summit, NJ 07901
Phone (908) 277-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120801000174 NJ Practitioner - Clinical Psychologist 7012173388 Practice locations: Pompton Lakes, NJ
I20200424002019 CT Practitioner - Clinical Psychologist 7012173388 Practice locations: Norwich, CT; Wethersfield, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Pompton Ave
Pompton Lakes, NJ 07442-1895
Phone (973) 835-6337

23 E Town St
Norwich, CT 06360-2401
Phone (732) 309-4744

493 Main St
Wethersfield, CT 06109-1818
Phone (732) 309-4744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJPSYCHOLOGIST2126NJMDClinical Psychologist
2047CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Behavioral Health Services PC Clinical PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548321623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10-12 KENT PLACE BLVD",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-277-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10-12 KENT PLACE BOULEVARD",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-277-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "PAMELA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "NJPSYCHOLOGIST2126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.