Individual provider Active NPI

Hava Eva Mendelberg, PH.D.

  • Psychologist
  • Princeton, NJ
National Provider Identifier
1891809455
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4315 Issued in NJ
Practice address
86 Snowden LN
Princeton, NJ 08540-3939
Phone
(609) 921-2213
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 912 WI
Psychologist 103T00000X 4315 NJ Primary

Addresses

Primary practice location

86 Snowden LN
Princeton, NJ 08540-3939

Mailing address

86 Snowden Lane
Princeton, NJ 08540
Phone (609) 921-2213

Other identifiers 1

IdentifierTypeStateIssuer
39024700MedicaidWI

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

LicenseStateTypeSpecialty
4315NJMDPsychologist
912WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Clinic Psychologist PastSince Jan 1, 2011 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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1891809455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 SNOWDEN LANE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-921-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 SNOWDEN LN",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403939",
            "telephone_number": "609-921-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELBERG",
        "first_name": "HAVA",
        "middle_name": "EVA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "912",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "4315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39024700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.