Specialized Therapy Associates LLC
NPI 1417293101ActiveOrganization· Nurse Practitioner· Hackensack, NJ
Nurse Practitioner in Hackensack, New Jersey, registered in NPPES in December 2012, part of Specialized Therapy Associates LLC. The authorized official on file is Vanessa Gourdine, PSY D, Director.
Overview
| NPI | 1417293101 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Specialized Therapy Associates LLC |
| NPI issued | Dec 27, 2012 |
| Last updated in NPPES | Dec 27, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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