Active NPI
Leo Joseph Selm III, PSY. D.
- Psychologist
- Pitman, NJ
National Provider Identifier
1598054900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100450200
- Practice address
- Box 268
Pitman, NJ 08071 - Phone
- (609) 922-0980
- NPI assigned
- Apr 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100450200 | NJ | Primary |
Addresses
Primary practice location
Box 268
Pitman, NJ 08071
Mailing address
Box 268
Pitman, NJ 08071
Phone (609) 922-0980
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100450200 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450224000000",
"number": "1598054900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 268",
"city": "PITMAN",
"state": "NJ",
"postal_code": "08071",
"telephone_number": "609-922-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOX 268",
"city": "PITMAN",
"state": "NJ",
"postal_code": "08071",
"telephone_number": "609-922-0980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELM",
"first_name": "LEO",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PSY. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-06",
"last_updated": "2015-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100450200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pitman, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.