Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103T00000X | Psychologist | | 35S100409300 | NEW JERSEY | No |
| 2 | 103TA0700X | Psychologist | Adult Development & Aging | 35S100409300 | NEW JERSEY | No |
| 3 | 103TC0700X | Psychologist | Clinical | 35S100409300 | NEW JERSEY | No |
| 4 | 103TC1900X | Psychologist | Counseling | 35S100409300 | NEW JERSEY | No |
| 5 | 103TF0000X | Psychologist | Family | 35S100409300 | NEW JERSEY | No |
| 6 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | 35S100409300 | NEW JERSEY | No |
| 7 | 103TR0400X | Psychologist | Rehabilitation | 35S100409300 | NEW JERSEY | No |
| 8 | 104100000X | Social Worker | | 44SW00117700 | NEW JERSEY | No |
| 9 | 106H00000X | Marriage & Family Therapist | | 37F100122400 | NEW JERSEY | No |
| 10 | 163W00000X | Registered Nurse | | 26NR04510500 | NEW JERSEY | No |
| 11 | 163WP0809X | Registered Nurse | Psychiatric/Mental Health, Adult | 26NR04510500 | NEW JERSEY | No |
| 12 | 364S00000X | Clinical Nurse Specialist | | 26NC04510500 | NEW JERSEY | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 076509APU | OTHER | NEW JERSEY | MEDICARE ID-PHD-ROSSI |
| 2 | S62617 | MEDICARE UPIN | NEW JERSEY | |
| 3 | 016408DBG | OTHER | NEW JERSEY | MEDICARE ID-CNS-INHEALTH |
| 4 | 4144007 | MEDICAID | NEW JERSEY | |
| 5 | 076509DBG | OTHER | NEW JERSEY | MEDICARE ID-PHD-INHEALTH |
| 6 | 143411APU | OTHER | NEW JERSEY | MEDICARE ID-CNS-ROSSI |
| 7 | 0023850 | MEDICAID | NEW JERSEY | |
| 8 | 314011 | MEDICARE PIN | NEW JERSEY | |
