NPIMap

Organization Active NPI

Specialized Therapy Associates LLC

  • Psychologist
  • Hackensack, NJ
National Provider Identifier
1851637557
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SPECIALIZED THERAPY ASSOCIATES LLC
Practice address
83 Summit Ave
2ND Floor
Hackensack, NJ 07601-1262
Phone
(201) 488-6678
Fax
(201) 342-4346
NPI assigned
Dec 27, 2012
Organization subpart
Yes
Parent organization
SPECIALIZED THERAPY ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Authorized official

Name
Dr. Vanessa Gourdine, PSY D
Title
Director
Phone
(201) 488-6678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X NJ Primary

Addresses

Primary practice location

83 Summit Ave
2ND Floor
Hackensack, NJ 07601-1262

Mailing address

PO Box 3016
South Hackensack, NJ 07606-1016
Phone (201) 488-6678

National Provider Directory

National Provider Directory
Tax ID family
Specialized Therapy Associates LLC7 organizations share this tax ID, including this one
Part of
Specialized Therapy Associates LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

83 Summit Ave
Ste 2
Hackensack, NJ 07601
Phone (201) 488-4849

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1851637557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3016",
            "city": "SOUTH HACKENSACK",
            "state": "NJ",
            "postal_code": "076061016",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SUMMIT AVE",
            "address_2": "2ND FLOOR",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011262",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED THERAPY ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALIZED THERAPY ASSOCIATES LLC",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "GOURDINE",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-488-6678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.