Individual provider Active NPI

Alisha M. Gonzales, PSY.D.

  • Clinical Psychologist
  • Paramus, NJ
National Provider Identifier
1629434790
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5564 Issued in NJ
Practice address
140 E Ridgewood Ave Ste 415
Paramus, NJ 07652-3915
Phone
(800) 275-3243
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 5564 NJ Primary

Addresses

Primary practice location

140 E Ridgewood Ave Ste 415
Paramus, NJ 07652-3915

Mailing address

140 E Ridgewood Ave Ste 415
Paramus, NJ 07652-3915
Phone (800) 275-3243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160215000142 NJ Practitioner - Clinical Psychologist 1951605849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5564NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Apr 1, 2022 Accepting new patients
NJ Behavioral Health Services PC Clinical CurrentSince Mar 1, 2021 Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Clinical Past Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1629434790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E RIDGEWOOD AVE STE 415",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523915",
            "telephone_number": "800-275-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E RIDGEWOOD AVE STE 415",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523915",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ALISHA",
        "middle_name": "M.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "5564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.