Individual provider Active NPI

Karolina Nicewicz, PSY.D.

  • Clinical Neuropsychologist
  • New Providence, NJ
National Provider Identifier
1790200343
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00623700 Issued in NJ
Practice address
219 South St Ste 212
New Providence, NJ 07974-2100
Phone
(973) 348-5118
NPI assigned
Aug 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 35SI00623700 NJ Primary
Psychologist 103T00000X

Addresses

Primary practice location

219 South St Ste 212
New Providence, NJ 07974-2100

Mailing address

59 W 7TH St
Bayonne, NJ 07002-2416
Phone (973) 348-5118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240601000252 NY Practitioner - Clinical Psychologist 5991247298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00623700NJMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karolina Nicewicz PSYD LLC Current Accepting new patients
True North Medical Group PC CurrentSince Apr 24, 2024 Accepting new patients
True North Medical Group PC CurrentSince Apr 24, 2024 Accepting new patients

Locations

219 South St
Ste 212
New Providence, NJ 07974
Phone (973) 348-5118

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

65 Columbus Ave
Staten Island, NY 10304

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: karolinanicewicz@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1790200343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 W 7TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022416",
            "telephone_number": "973-348-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 SOUTH ST STE 212",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742100",
            "telephone_number": "973-348-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICEWICZ",
        "first_name": "KAROLINA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00623700",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Providence, NJ

Sources for this page

Verify at the official NPI Registry.