Individual provider Active NPI

Edna Celeste Rodriguez, PSYD.

  • Clinical Psychologist
  • Delran, NJ
National Provider Identifier
1588467658
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00626900 Issued in NJ
Practice address
19 Liberty TRL
Delran, NJ 08075-1341
Phone
(856) 655-5097
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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 35SI00626900 NJ Primary

Addresses

Primary practice location

19 Liberty TRL
Delran, NJ 08075-1341

Mailing address

19 Liberty TRL
Delran, NJ 08075-1341
Phone (856) 655-5097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250630001503 NJ Practitioner - Clinical Psychologist 2466965868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Behavioral Health Services PCGroup PAC ID 0648288712, 51 clinicians

Practice addresses (Care Compare)

140 E Ridgewood Ave
Suite 415
Paramus, NJ 07652-3915
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Behavioral Health Services PC Clinical CurrentSince Jun 2, 2025 Accepting new patients

Locations

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1588467658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LIBERTY TRL",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751341",
            "telephone_number": "856-655-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 LIBERTY TRL",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751341",
            "telephone_number": "856-655-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EDNA",
        "middle_name": "CELESTE",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00626900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

Verify at the official NPI Registry.