NPIMap

Organization Active NPI

Avita Integrative Care, LLC

Doing business as Avita iCare

  • Clinical Psychologist
  • Teaneck, NJ
National Provider Identifier
1821530148
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
AVITA INTEGRATIVE CARE, LLC
Doing business as
Avita iCare
Practice address
763 River Rd FL 1
Teaneck, NJ 07666-1619
Phone
(888) 242-2732
Fax
(888) 242-2732
NPI assigned
Nov 17, 2016
Last updated
Aug 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Dr. Kalman Khodik, PSY.DNPI 1598190050
Title
Executive Director
Phone
(888) 242-2732

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

763 River Rd FL 1
Teaneck, NJ 07666-1619

Mailing address

763 River Rd FL 1
Teaneck, NJ 07666-1619
Phone (888) 242-2732

Other names 1

  • Avita iCare Doing business as

National Provider Directory

National Provider Directory

Locations

440 West St
Ste 312
Fort Lee, NJ 07024
Phone (888) 242-2732

763 River Rd
#1
Teaneck, NJ 07666
Phone (888) 242-2732

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1821530148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 RIVER RD FL 1",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661619",
            "telephone_number": "888-242-2732",
            "fax_number": "888-242-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 RIVER RD FL 1",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661619",
            "telephone_number": "888-242-2732",
            "fax_number": "888-242-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVITA INTEGRATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "KHODIK",
        "authorized_official_first_name": "KALMAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "888-242-2732",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita iCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.