Provider Demographics
NPI:1265446181
Name:RSM PSYCHOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:RSM PSYCHOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:SCOLARO
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-895-1070
Mailing Address - Street 1:281 WITHERSPOON ST.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-895-1070
Mailing Address - Fax:609-896-2030
Practice Address - Street 1:281 WITHERSPOON ST.
Practice Address - Street 2:SUITE 230
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-895-1070
Practice Address - Fax:609-896-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJSI02148103G00000X, 103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ805974Medicare ID - Type Unspecified