Active NPI
Zasah Sussanne Khademi, LPC
- Counseling Psychologist
- West Orange, NJ
National Provider Identifier
1710657754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 37PC00786900
- Practice address
- 4 Dawes Ave
West Orange, NJ 07052-2317 - Phone
- (201) 618-8572
- NPI assigned
- Sep 20, 2021
- Last updated
- Sep 20, 2021
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 37PC00786900 | NJ | Primary |
Addresses
Primary practice location
4 Dawes Ave
West Orange, NJ 07052-2317
Mailing address
4 Dawes Ave
West Orange, NJ 07052-2317
Phone (201) 618-8572
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 |
|---|---|---|---|
| 37PC00786900 | NJ | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1710657754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 DAWES AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522317",
"telephone_number": "201-618-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 DAWES AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522317",
"telephone_number": "201-618-8572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHADEMI",
"first_name": "ZASAH",
"middle_name": "SUSSANNE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-20",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NJ",
"license": "37PC00786900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.