Psychoanalytic Clinic Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PSYCHOANALYTIC CLINIC INC.

Practice address

121 Cedar Lane
Ste 3a
Teaneck, NJ 07666

Phone

(201) 836-1065

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Neil B Wilson, PH.D

Title

Co-Director

Phone

(201) 836-3032

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1912405176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CEDAR LANE",
            "address_2": "STE 3A",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-836-1065",
            "fax_number": "201-836-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CEDAR LANE",
            "address_2": "STE 3A",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-836-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOANALYTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "201-836-3032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.