Individual provider Active NPI

Elvia Valencia

  • Adult Development & Aging Psychologist
  • Cliffside Park, NJ
National Provider Identifier
1811093370
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
35SI00434000 Issued in NJ
Practice address
152 Pine St
Cliffside Park, NJ 07010-1018
Phone
(201) 255-4001
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 35SI00434000 NJ Primary

Addresses

Primary practice location

152 Pine St
Cliffside Park, NJ 07010-1018

Mailing address

152 Pine St
Cliffside Park, NJ 07010-1018
Phone (201) 255-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20061129000388 NJ Practitioner - Clinical Psychologist 6800894858 Practice locations: Berkeley Heights, NJ; Cliffside Park, NJ; Perth Amboy, NJ; Rochelle Park, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

152 Pine St
Cliffside Park, NJ 07010-1018
Phone (201) 255-4001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Onlinepsychdoc, LLC Adult Development & Aging Current Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1811093370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PINE ST",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101018",
            "telephone_number": "201-255-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 PINE ST",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101018",
            "telephone_number": "201-255-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "ELVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NJ",
            "license": "35SI00434000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

Verify at the official NPI Registry.