Mark Edward Hersh

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Practice address

220 Fernhead Ave
Monroe, NJ 08831-8736

Phone

(732) 995-9784

NPI assigned

Sep 3, 2019

Last updated

Sep 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Person Centered Squared PC2

  dba PC2

  • Developmental Disabilities Clinic/Center
  • Monroe TWP, NJ
  • NPI 1952902470
  NPD Authorized official

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1851949879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FERNHEAD AVE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088318736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FERNHEAD AVE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088318736",
            "telephone_number": "732-995-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSH",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "102X00000X",
            "taxonomy_group": "",
            "desc": "Poetry Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DDD",
            "identifier": "001",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "share",
            "affiliation": "N",
            "endpointDescription": "end user interface",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "text",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "220 Fernhead Ave",
            "city": "Monroe",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088318736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intellectual & Developmental Disabilities Psychologist in Monroe, NJ
• Providers in Monroe, NJ by specialty
• Intellectual & Developmental Disabilities Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.