| Mid-atlantic Psychological Services | |
|
75 Raritan Ave Ste 225 Highland Park NJ 08904-2442 | |
| (973) 433-5868 | |
| Not Available |
| Full Name | Mid-atlantic Psychological Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 75 Raritan Ave Ste 225, Highland Park, New Jersey |
| Authorized Official Name and Position | Mason Shepherd (PRESIDENT) |
| Authorized Official Contact | 9734335868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-atlantic Psychological Services 1062 Livingston Ave Unit 7071 New Brunswick NJ 08902-8003 Ph: (973) 433-5868 | Mid-atlantic Psychological Services 75 Raritan Ave Ste 225 Highland Park NJ 08904-2442 Ph: (973) 433-5868 |
| NPI Number | 1508503038 |
|---|---|
| Provider Enumeration Date | 05/16/2022 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Medicare PECOS PAC ID | 5991187957 |
|---|---|
| Medicare Enrollment ID | O20220808001500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508503038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mason Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558903005 PECOS PAC ID: 6800278862 Enrollment ID: I20220808001774 |
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