Active NPI
Shiri H Sella, PSYD
- Psychologist
- Marlton, NJ
National Provider Identifier
1639474190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4824
- Practice address
- 8004 Lincoln Dr W
Suite D
Marlton, NJ 08053-3213 - Phone
- (609) 682-3115
- NPI assigned
- Jan 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4824 | NJ | Primary |
| Psychologist | 103T00000X | PS016789 | PA |
Addresses
Primary practice location
8004 Lincoln Dr W
Suite D
Marlton, NJ 08053-3213
Mailing address
8004 Lincoln Dr W
Suite D
Marlton, NJ 08053-3213
Phone (609) 682-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4824 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386115200000",
"number": "1639474190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8004 LINCOLN DR W",
"address_2": "SUITE D",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533213",
"telephone_number": "609-682-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8004 LINCOLN DR W",
"address_2": "SUITE D",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533213",
"telephone_number": "609-682-3115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLA",
"first_name": "SHIRI",
"middle_name": "H",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-14",
"last_updated": "2013-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "4824",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS016789",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.