Active NPI
Tiffany Channing, PSYD
- Clinical Psychologist
- Mount Laurel, NJ
National Provider Identifier
1861003394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- NJDCATEMP-025701
- Practice address
- 3900 Church Rd
Mount Laurel, NJ 08054-1108 - Phone
- (844) 234-8387
- Fax
- (856) 429-4755
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | NJDCATEMP-025701 | NJ | Primary |
Addresses
Primary practice location
3900 Church Rd
Mount Laurel, NJ 08054-1108
Mailing address
1255 Caldwell Rd
Cherry Hill, NJ 08034-3220
Phone (844) 234-8387
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3900 Church Rd
Mount Laurel, NJ 08054-1108
Phone (800) 774-5516
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJDCATEMP-025701 | NJ | MD | Clinical Psychologist |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- Cherry Hill, NJ
- NPI 1720121106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1861003394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 CALDWELL RD",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080343220",
"telephone_number": "844-234-8387",
"fax_number": "856-429-4755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 CHURCH RD",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541108",
"telephone_number": "844-234-8387",
"fax_number": "856-429-4755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANNING",
"first_name": "TIFFANY",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-10",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "NJDCATEMP-025701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Laurel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.