Organization Active NPI

Shawn Sobkowski, Ed.D., P.a.

  • Clinical Psychologist
  • Highland Park, NJ
National Provider Identifier
1609104868
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SHAWN SOBKOWSKI, ED.D., P.A.
Practice address
8 N 2ND Ave
Highland Park, NJ 08904-2419
Phone
(732) 246-8414
NPI assigned
Nov 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Dr. Shawn Sobkowski, ED.D.NPI 1962526004
Title
President
Phone
(732) 246-8414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

8 N 2ND Ave
Highland Park, NJ 08904-2419

Mailing address

8 N 2ND Ave
Highland Park, NJ 08904-2419
Phone (732) 246-8414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100129000511 NJ Part B Supplier - Clinic/Group Practice 4183767106 Receives reassigned benefits from 1 practitioner
Practice locations: Highland Park, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1609104868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N 2ND AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042419",
            "telephone_number": "732-246-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N 2ND AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042419",
            "telephone_number": "732-246-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN SOBKOWSKI, ED.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "SOBKOWSKI",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-246-8414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.