Individual provider Active NPI

Sean Hiscox, PH.D.

  • Clinical Psychologist
  • Somerville, NJ
National Provider Identifier
1609910975
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3963 Issued in NJ
Practice address
25 N Doughty Ave
Somerville, NJ 08876-1811
Phone
(980) 526-1177
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

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
Clinical Psychologist 103TC0700X 3963 NJ Primary

Addresses

Primary practice location

25 N Doughty Ave
Somerville, NJ 08876-1811

Mailing address

25 N Doughty Ave
Somerville, NJ 08876-1811
Phone (980) 526-1177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 3, 2024 through Jul 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3963NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609910975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N DOUGHTY AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761811",
            "telephone_number": "980-526-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N DOUGHTY AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088761811",
            "telephone_number": "980-526-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISCOX",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "3963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.