Active NPI
Sandra Marie Carlisle, PSY.D.
- Psychologist
- Demarest, NJ
National Provider Identifier
1710138409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100459000
- Practice address
- 14 Pine Hill Rd
Demarest, NJ 07627-1309 - Phone
- (201) 424-5197
- NPI assigned
- Oct 1, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100459000 | NJ | Primary |
Addresses
Primary practice location
14 Pine Hill Rd
Demarest, NJ 07627-1309
Mailing address
17 Mountain Trail
Sandyston, NJ 07826
Phone (973) 948-0886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100459000 | NJ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Associates of North Jersey LLC | Past | Accepting new patients |
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.
-
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- Hackettstown, NJ
- NPI 1396802682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1710138409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MOUNTAIN TRAIL",
"city": "SANDYSTON",
"state": "NJ",
"postal_code": "07826",
"telephone_number": "973-948-0886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 PINE HILL RD",
"city": "DEMAREST",
"state": "NJ",
"postal_code": "076271309",
"telephone_number": "201-424-5197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLISLE",
"first_name": "SANDRA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-01",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100459000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Demarest, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.