Provider Demographics
NPI:1811070824
Name:ADVANCED PSYCHOLOGICAL SPECIALISTS, LLC
Entity type:Organization
Organization Name:ADVANCED PSYCHOLOGICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:JUST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-447-2242
Mailing Address - Street 1:1 PROSPECT ST # 5-7
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4404
Mailing Address - Country:US
Mailing Address - Phone:201-447-2242
Mailing Address - Fax:201-447-4377
Practice Address - Street 1:1 PROSPECT ST # 5-7
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4404
Practice Address - Country:US
Practice Address - Phone:201-447-2242
Practice Address - Fax:201-447-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103GC0700X103G00000X
NJ103TB0200X103TB0200X
NJ103TP2700X103T00000X
NJ103TP2701X103TP2701X
NJ103TS0200X103TS0200X
NJ103TC0700X103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========VOtherBLUE CROSS/BLUE SHIELD
NJ=========VOtherBLUE CROSS/BLUE SHIELD