Nicole Dock, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00529200 Issued in NJ

Practice address

111 Celestino CT
Blackwood, NJ 08012-4435

Phone

(862) 763-7965

NPI assigned

Aug 13, 2014

Last updated

Aug 13, 2014By 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

Other names 1

• Dr. Nicole Dock Professional name

Medicare fee-for-service enrollment

Enrolled in NJ, MD, DC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  Medicare reassignment Care Compare group NPD
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  DC, MD

  Medicare reassignment Care Compare group NPD
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376
  Medicare reassignment NPD
• Sailor Health Medical of New Jersey, P.C.

  • Psychologist
  • Miami, FL
  • NPI 1578421798

  NJ

  Medicare reassignment

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1619376852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CELESTINO CT",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080124435",
            "telephone_number": "862-763-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CELESTINO CT",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080124435",
            "telephone_number": "862-763-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCK",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00529200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DOCK",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.