Active NPI
Beverly Brysk, PHD
- Cognitive & Behavioral Psychologist
- Montclair, NJ
National Provider Identifier
1790823664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 5103005
- Practice address
- 303 Claremont Ave
Montclair, NJ 07042-2813 - Phone
- (973) 783-2121
- Fax
- (973) 783-0112
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 5103005 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 8103005 | NJ | |
| Psychologist | 103T00000X | 5103005 | NJ |
Addresses
Primary practice location
303 Claremont Ave
Montclair, NJ 07042-2813
Mailing address
303 Claremont Ave
Montclair, NJ 07042
Phone (973) 783-2121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 6, 2012 through Nov 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5103005 | NJ | MD | Cognitive & Behavioral Psychologist |
| 8103005 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1790823664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 CLAREMONT AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "07042",
"telephone_number": "973-783-2121",
"fax_number": "973-783-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 CLAREMONT AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422813",
"telephone_number": "973-783-2121",
"fax_number": "973-783-0112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYSK",
"first_name": "BEVERLY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NJ",
"license": "5103005",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "8103005",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "5103005",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.