Mark Kitzie, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3971 Issued in NJ

Practice address

154 Tamarack Cir
Skillman, NJ 08558-2021

Phone

(609) 430-2121

Fax

(609) 430-2121

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Youth Development Clinic of Newark

  • Community/Behavioral Health Agency
  • Newark, NJ
  • NPI 1235937269
  NPD Authorized official
• Youth Development Clinic of Newark

  • Community/Behavioral Health Agency
  • Newark, NJ
  • NPI 1316239643
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649297367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MILLERS GROVE RD",
            "city": "BELLE MEAD",
            "state": "NJ",
            "postal_code": "085024306",
            "telephone_number": "908-359-9994",
            "fax_number": "908-359-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 TAMARACK CIR",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "085582021",
            "telephone_number": "609-430-2121",
            "fax_number": "609-430-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZIE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "3971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenbro Enterprises, LLC
• Tessa Kettelkamp
• Jacqueline Khouzam, MSW, LSW
• Mary Elizabeth Kindig, MSW
• Lorna Kirby, LSW
• Melissa Hall Klepacki, M.AC.
• Diane J Kmec, M.D.,L.L.C.
• Laura Gwen Kogan, PSY.D.
• Jennifer Kole, PT
• Pablo Lapuerta, MD

• Psychologist in Skillman, NJ
• Providers in Skillman, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.