Active NPI
Henry Madamba
- Counseling Psychologist
- Linwood, NJ
National Provider Identifier
1619344496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 37PC00096500
- Practice address
- 222 New Rd Ste 405
Linwood, NJ 08221-1283 - Phone
- (609) 289-5354
- Fax
- (609) 266-0459
- NPI assigned
- Aug 27, 2015
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 37PC00096500 | NJ | Primary |
Addresses
Primary practice location
222 New Rd Ste 405
Linwood, NJ 08221-1283
Mailing address
750 Pasadena Dr
Northfield, NJ 08225-1169
Phone (609) 287-0697
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00096500 | NJ | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1619344496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 PASADENA DR",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "082251169",
"telephone_number": "609-287-0697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 NEW RD STE 405",
"city": "LINWOOD",
"state": "NJ",
"postal_code": "082211283",
"telephone_number": "609-289-5354",
"fax_number": "609-266-0459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADAMBA",
"first_name": "HENRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-27",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NJ",
"license": "37PC00096500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Linwood, NJ
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.