Odette Cohn, PHD
Individual provider Active NPI Clinical Psychologist · Rutherford, NJ
NPI 1679798169 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679798169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3385 (NJ)
- Practice address
- 17 Sylvan St
Suite 103a
Rutherford, NJ 07070-2037 - Phone
- (201) 804-2575
- Fax
- (201) 797-5281
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
100 Carlyle Dr
Apt 4MN
Cliffside Park, NJ 07010-3508
71 Union Ave
Suite 107a
Rutherford, NJ 07070-1279
Phone (201) 804-2575
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050524000344 | NJ | Practitioner - Clinical Psychologist | 3971545617 | Practice locations: Rutherford, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3385 | NJ | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3385 | NJ | Yes |
Addresses
Primary practice location
17 Sylvan St
Suite 103a
Rutherford, NJ 07070-2037
Mailing address
17 Sylvan St
Suite 103a
Rutherford, NJ 07070-2037
Phone (201) 804-2575
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All providers in Rutherford, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.