Mona W. Birk, PHD, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MONA W. BIRK, PHD, LLC

Practice address

32 Hopkinson CT
Basking Ridge, NJ 07920-2982

Phone

(908) 306-0774

Fax

(908) 306-0607

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Mona Birk, PHD

Title

President

Phone

(908) 307-3768

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1790199537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HOPKINSON CT",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202982",
            "telephone_number": "908-306-0774",
            "fax_number": "908-306-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 HOPKINSON CT",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202982",
            "telephone_number": "908-306-0774",
            "fax_number": "908-306-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA W. BIRK, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "BIRK",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-307-3768",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": "NJ",
            "license": "26NC04510500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.