Active NPI
Melissa Klika Mack, PSY.D.
- Clinical Psychologist
- Madison, NJ
National Provider Identifier
1942622147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5134
- Practice address
- 13 Madison Ave
Madison, NJ 07940-1400 - Phone
- (908) 512-6027
- Fax
- (973) 695-1483
- NPI assigned
- Jan 8, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5134 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 019839 | NY |
Addresses
Primary practice location
13 Madison Ave
Madison, NJ 07940-1400
Mailing address
8 Longview Ave
Madison, NJ 07940-1712
Phone (908) 512-6027
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5134 | NJ | MD | Clinical Psychologist |
| 019839 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1942622147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 LONGVIEW AVE",
"city": "MADISON",
"state": "NJ",
"postal_code": "079401712",
"telephone_number": "908-512-6027",
"fax_number": "973-695-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 MADISON AVE",
"city": "MADISON",
"state": "NJ",
"postal_code": "079401400",
"telephone_number": "908-512-6027",
"fax_number": "973-695-1483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLIKA MACK",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-08",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "5134",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019839",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, NJ
- Brigitte Kelly, LCSW
- Barbara Kennard, MSW, LCSW
- William White Kennard Jr., M.S.W., L.C.S.W.
- Harvey Ronald Kennedy, M.D.
- Alyssa Nikole Kist, DMD
- Robert Konieczny, D.C.
- Yvonne Michelle Krasner-Cohen, LPC, LCADC
- Krieck Enterprises LLC (Living Free Home)
- Krieck Enterprises LLC (Homecare America)
- George P Kryzaniwsky, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.