Chassia Gervis Boczko, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35S100428500 Issued in NJ

Practice address

401A S Van Brunt St
Suite 204
Englewood, NJ 07631-4600

Phone

(201) 894-9011

NPI assigned

May 20, 2008

Last updated

May 20, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1609033273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401A S VAN BRUNT ST",
            "address_2": "SUITE 204",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314600",
            "telephone_number": "201-894-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401A S VAN BRUNT ST",
            "address_2": "SUITE 204",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314600",
            "telephone_number": "201-894-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCZKO",
        "first_name": "CHASSIA",
        "middle_name": "GERVIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100428500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.