Active NPI
Solace Therapy and Evaluation, LLC
- Clinical Psychologist
- Lakewood, NJ
National Provider Identifier
1780132415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00566100
- Legal business name
- SOLACE THERAPY AND EVALUATION, LLC
- Practice address
- 525 Route 70
Suite a-3
Lakewood, NJ 08701-5847 - Phone
- (848) 218-1601
- NPI assigned
- Sep 11, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lydia Zarrella-Timmerman, PSY.D.
- Title
- Licensed Psychologist/Owner
- Phone
- (848) 218-1601
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00566100 | NJ | Primary |
Addresses
Primary practice location
525 Route 70
Suite a-3
Lakewood, NJ 08701-5847
Mailing address
525 Route 70
Suite a-3
Lakewood, NJ 08701-5847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161019000404 | NJ | Part B Supplier - Clinic/Group Practice | 7517255821 |
Receives reassigned benefits from 4 practitioners Practice locations: Wall, NJ; Farmingdale, NJ |
National Provider Directory
National Provider DirectoryLocations
525 Route 70
Ste A3
Lakewood, NJ 08701
Phone (732) 364-0040
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Social Worker
- East Brunswick, NJ
- NPI 1861141814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1473552000000",
"number": "1780132415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 ROUTE 70",
"address_2": "SUITE A-3",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 ROUTE 70",
"address_2": "SUITE A-3",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015847",
"telephone_number": "848-218-1601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOLACE THERAPY AND EVALUATION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-09-11",
"last_updated": "2016-09-11",
"status": "A",
"authorized_official_last_name": "ZARRELLA-TIMMERMAN",
"authorized_official_first_name": "LYDIA",
"authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
"authorized_official_telephone_number": "848-218-1601",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00566100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.