Individual provider Active NPI

Sara Marie Shane, PSYD

  • Psychologist
  • Voorhees, NJ
National Provider Identifier
1871822031
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00632800 Issued in NJ
Practice address
1010 Haddonfield Berlin Rd Ste 410
Voorhees, NJ 08043-3514
Phone
(856) 809-2940
NPI assigned
Dec 17, 2009
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X NU
Psychologist 103T00000X PS018760 PA
Psychologist 103T00000X 35SI00632800 NJ Primary

Addresses

Primary practice location

1010 Haddonfield Berlin Rd Ste 410
Voorhees, NJ 08043-3514

Mailing address

1010 Haddonfield Berlin Rd Ste 410
Voorhees, NJ 08043-3514
Phone (856) 809-2940

Other practice location 1

1021 S 21st St
Philadelphia, PA 19146-2634
Phone (215) 890-6277

Other practice location 2

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone (215) 955-8420

Other practice location 3

630 Fairview Rd Ste 201
Swarthmore, PA 19081-2335
Phone (856) 809-2940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230227003075 NJ Practitioner - Clinical Psychologist 2365815032 Reassigns benefits to 1 organization
I20230425000046 PA Practitioner - Clinical Psychologist 2365815032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00632800NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Jefferson University PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1871822031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 HADDONFIELD BERLIN RD STE 410",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433514",
            "telephone_number": "856-809-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HADDONFIELD BERLIN RD STE 410",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433514",
            "telephone_number": "856-809-2940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 S 21st St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191462634",
            "country_code": "US",
            "telephone_number": "215-890-6277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 Chestnut St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074405",
            "country_code": "US",
            "telephone_number": "215-955-8420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Fairview Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Swarthmore",
            "state": "PA",
            "postal_code": "190812335",
            "country_code": "US",
            "telephone_number": "856-809-2940",
            "fax_number": "856-336-2231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANE",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018760",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00632800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.