Karen Beth Willick, MS

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

46TR00423800 Issued in NJ

Practice address

1415 Queen Anne Rd Ste 100
Teaneck, NJ 07666-3521

Phone

(201) 837-9993

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1689247751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W PALISADE AVE APT 2229",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312745",
            "telephone_number": "201-233-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 QUEEN ANNE RD STE 100",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663521",
            "telephone_number": "201-837-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLICK",
        "first_name": "KAREN",
        "middle_name": "BETH",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00423800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "karen@potsot.com",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Pediatric Occupational Therapy Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 Queen Anne Rd Ste 100",
            "city": "Teaneck",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076663521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "karen@potsot.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 Queen Anne Rd Ste 100",
            "city": "Teaneck",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076663521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Occupational Therapist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Pediatric Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.