Active NPI
Bernice Davis
- Clinical Psychologist
- East Orange, NJ
National Provider Identifier
1871992396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35S100478500
- Practice address
- 55 Washington St
401
East Orange, NJ 07017-1495 - Phone
- (973) 337-5029
- NPI assigned
- Aug 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 35S100478500 | NJ | Primary |
Addresses
Primary practice location
55 Washington St
401
East Orange, NJ 07017-1495
Mailing address
75 La France Ave
Bloomfield, NJ 07003-7606
Phone (973) 337-5029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100478500 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis & Davis Psychology and Consulting Services | Clinical | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Bloomfield, NJ
- NPI 1922663160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1871992396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 LA FRANCE AVE",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "070037606",
"telephone_number": "973-337-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WASHINGTON ST",
"address_2": "401",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070171495",
"telephone_number": "973-337-5029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BERNICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-20",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35S100478500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.