Individual provider Active NPI

William L Shinefield, PSY.D.

  • Clinical Psychologist
  • Mount Laurel, NJ
National Provider Identifier
1912925066
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00299400 Issued in NJ
Practice address
3804 Church Rd
Mount Laurel, NJ 08054-1106
Phone
(609) 744-3393
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00299400 NJ Primary

Addresses

Primary practice location

3804 Church Rd
Mount Laurel, NJ 08054-1106

Mailing address

PO Box 547
Mount Laurel, NJ 08054-0547
Phone (609) 744-3393

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000434 NJ Practitioner - Clinical Psychologist 7810086683 Practice locations: Mount Laurel, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3804 Church Rd
Mount Laurel, NJ 08054-1106
Phone (609) 744-3393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00299400NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
William L. Shinefield Clinical PastSince Jan 1, 1990 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1912925066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080540547",
            "telephone_number": "609-744-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541106",
            "telephone_number": "609-744-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINEFIELD",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00299400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.