Larissa Redziniak

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00730000 Issued in NJ

Practice address

65 Mechanic St Ste 203
Red Bank, NJ 07701-1852

Phone

(855) 284-7483

NPI assigned

Dec 18, 2023

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment Care Compare group NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1952179079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MECHANIC ST STE 203",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011852",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDZINIAK",
        "first_name": "LARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00730000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Red Bank Family Pharmacy Inc (Red Bank Family Pharmacy)
• Red Bank Gastroenterology Associates, PA
• Red Bank Neurorehabilitation Associates, LLC
• Red Bank Pharmacy (Professional Pharmacy)
• Red Bank Public School District
• Amy Boltz Regina, R.D.
• Kyle Reinhardt
• Remm Cognitive Training II, LLC (LearningRx)
• Nancy Reng
• Kevin Reyes

• Clinical Psychologist in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.