Individual provider Active NPI

Lauren Stern, PSY.D

  • Clinical Psychologist
  • Montclair, NJ
National Provider Identifier
1619125028
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35S100502800 Issued in NJ
Practice address
460 Bloomfield Ave
Suite 209
Montclair, NJ 07042-3582
Phone
(973) 797-9669
Fax
(973) 228-4111
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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 35S100502800 NJ Primary

Addresses

Primary practice location

460 Bloomfield Ave
Suite 209
Montclair, NJ 07042-3582

Mailing address

116 Orton Rd
West Caldwell, NJ 07006-8251
Phone (973) 303-0957

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35S100502800NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1619125028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 ORTON RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068251",
            "telephone_number": "973-303-0957",
            "fax_number": "973-228-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BLOOMFIELD AVE",
            "address_2": "SUITE 209",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423582",
            "telephone_number": "973-797-9669",
            "fax_number": "973-228-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100502800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.