Individual provider Active NPI

Olivia Rose Marie Lewis Chang, PHD

  • Psychologist
  • Union, NJ
National Provider Identifier
1588743553
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
NJ3615 Issued in NJ
Practice address
2424 Morris Avenue
Union, NJ 07083
Phone
(908) 687-7797
Fax
(609) 688-1800
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

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
Psychologist 103T00000X NJ3615 NJ Primary

Addresses

Primary practice location

2424 Morris Avenue
Union, NJ 07083

Mailing address

2424 Morris Avenue
Union, NJ 07083
Phone (908) 687-7797

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
I20150930001051 NJ Practitioner - Clinical Psychologist 3476861105 Practice locations: Princeton, NJ; Union, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2424 Morris Ave
Suite 103
Union, NJ 07083-5710
Phone (908) 687-7797

2424 Morris Ave
Suite 103
Union, NJ 07083-5730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NJ3615NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588743553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 MORRIS AVENUE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-687-7797",
            "fax_number": "609-688-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 MORRIS AVENUE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-687-7797",
            "fax_number": "609-688-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS CHANG",
        "first_name": "OLIVIA",
        "middle_name": "ROSE MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "NJ3615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.