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MONTCLAIR MEMORY CLINIC LLC
NPI 1114396835
Clinical Neuropsychologist in Montclair, NJ

Active since September 23, 2015
70 PARK STREET, SUITE 207, MONTCLAIR, NJ 07042(973) 743-4555(973) 743-4055 Get Directions Write a Review

NPPES record last updated: April 15, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Montclair Memory Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTCLAIR MEMORY CLINIC LLC (NPI 1114396835) is a healthcare organization registered as a clinical neuropsychologist in Montclair, New Jersey and active in the NPI registry since September 2015. The organization lists Jacqueline A Rondeau, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1114396835
Entity TypeOrganization
Primary Taxonomy103G00000X
Legal Business NameMONTCLAIR MEMORY CLINIC LLC
Location Address70 PARK STREET, SUITE 207Montclair, NJ 07042-2960
Mailing AddressPo Box 8121Glen Ridge, NJ 07028-8121 · (973) 743-4555 · Fax (973) 743-4055
Phone(973) 743-4555
Fax(973) 743-4055
Organization SubpartNo
Authorized OfficialJacqueline A RondeauClinical Director · (973) 743-4555
Enumeration DateSeptember 23, 2015
Last NPPES UpdateApril 15, 2016
✔ NPI 1114396835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in NJ · 35SI00390000
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 35SI00390000 (NJ)
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
70 PARK STREET, Montclair, NJ 07042
Open in Google Maps ↗

Other Identifiers 2

Medicare PIN049043NJ
Medicaid0051560NJ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Montclair Memory Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Montclair Memory Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Elizabet Santana Marmon-Halm, PSY.D.
Clinical Psychologist
NPI 1487282901
70 PARK ST
Montclair, NJ 07042
(973) 746-4555
✔ PECOS✔ Accepts MedicareSame address
Jacqueline Rondeau, PSY.D.
Clinical Psychologist
NPI 1285622217
28 VALLEY RD
Montclair, NJ 07042
(973) 746-4555
✔ PECOS✔ Accepts Medicare0.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Montclair Memory Clinic LLC's NPI number?

The NPI number for Montclair Memory Clinic LLC is 1114396835. It was assigned to this organization in the NPPES registry on September 23, 2015.

Where is Montclair Memory Clinic LLC located?

Montclair Memory Clinic LLC is located at 70 Park Street Suite 207, Montclair, NJ 07042. The listed phone number is (973) 743-4555.

What is Montclair Memory Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Montclair Memory Clinic LLC enrolled in Medicare?

Yes. Montclair Memory Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Montclair Memory Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Clinical Psychologist, reassign their Medicare billing to Montclair Memory Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Montclair Memory Clinic LLC was last updated on April 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.