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General NPI Number Information
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NPI Number | 1376663096
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCHOLOGY SYSTEM PC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 4000 STATE ROUTE 66 STE 331
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City | TINTON FALLS
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State | NJ
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Zip | 07753-7300
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Country | US
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Telephone | 732-988-4431
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Fax | 732-988-7123
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Provider Business Mailing Address
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Address Line | 4000 ROUTE 66 STE 331
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City | TINTON FALLS
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State | NJ
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Zip | 07753-7300
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Country | US
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Telephone | 732-988-3441
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Fax | 732-988-7123
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANITA CATHERINE WATKINS-SICA
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Credential |
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Telephone | 732-988-3441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3SS100151900
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License Number State | NJ
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