Individual provider Active NPI

Beverly Tignor, PHD

  • Psychologist
  • Mendham, NJ
National Provider Identifier
1811565013
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100106100 Issued in NJ
Practice address
5 Cold Hill Rd S
Mendham, NJ 07945-3230
Phone
(973) 543-6438
NPI assigned
Jun 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35S100106100 NJ
Psychologist 103T00000X 35S100106100 NJ Primary

Addresses

Primary practice location

5 Cold Hill Rd S
Mendham, NJ 07945-3230

Mailing address

PO Box 387
Mendham, NJ 07945-0387
Phone (973) 543-6438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35S100106100NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1811565013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079450387",
            "telephone_number": "973-543-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COLD HILL RD S",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079453230",
            "telephone_number": "973-543-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGNOR",
        "first_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100106100",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100106100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.