Lydia Zarrella-Timmerman, PSY.D.

Individual provider Active NPI Clinical Psychologist · Farmingdale, NJ

NPI 1629522016 · NPPES record last updated Aug 19, 2021

Key facts

NPI
1629522016
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
35SI00566100 (NJ)
Practice address
43 Main St
Farmingdale, NJ 07727-1340
Phone
(848) 218-1601
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Solace Therapy and Evaluation, LLC (3 clinicians)

Practice addresses (Care Compare)

3350 Hwy 138
Suite 128
Wall Township, NJ 07719-9694
Phone (848) 218-1601

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161019000552 NJ Practitioner - Clinical Psychologist 8426346735 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
35SI00566100NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Therapy and Evaluation, LLC Clinical Current
since Aug 18, 2016
Accepting new patients

Locations

525 Route 70
Ste A3
Lakewood, NJ 08701
Phone (732) 364-0040

3350 State Route 138
Ste 128
Wall Township, NJ 07719
Phone (732) 280-2727

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00566100 NJ Yes

Addresses

Primary practice location

43 Main St
Farmingdale, NJ 07727-1340

Mailing address

43 Main St
Farmingdale, NJ 07727-1340
Phone (848) 218-1601

Other providers in Farmingdale, NJ

All providers in Farmingdale, NJ · Clinical Psychologist in New Jersey

Sources for this page

Verify at the official NPI Registry.