ARCHETYPE PSYCHOLOGICAL SERVICES, LLC
NPI 1952964611
Community/Behavioral Health in West Orange, NJ

Q: What is Archetype Psychological Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since April 18, 2019

444 NORTHFIELD AVE, WEST ORANGE, NJ 07052(646) 820-5477 Get Directions Write a Review

NPPES record last updated: April 18, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Archetype Psychological Services, Llc NPPES

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

ARCHETYPE PSYCHOLOGICAL SERVICES, LLC (NPI 1952964611) is a healthcare organization registered as a community/behavioral health in West Orange, New Jersey and active in the NPI registry since April 2019. The organization lists Wendy Wilson-poth, Owner, as its authorized official.

NPPES Registry Identity

NPI1952964611

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameARCHETYPE PSYCHOLOGICAL SERVICES, LLC

Location Address444 NORTHFIELD AVEWest Orange, NJ 07052-3012

Mailing Address111 Allen StNetcong, NJ 07857-1222 · (973) 527-4464

Phone(646) 820-5477

Organization SubpartNo

Authorized OfficialWendy Wilson-pothOwner · (646) 820-5477

Enumeration DateApril 18, 2019

✔ NPI 1952964611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

444 NORTHFIELD AVE, West Orange, NJ 07052

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Archetype Psychological Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Archetype Psychological Services, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Wendy Wilson-Poth, PH.D.

Clinical Psychologist

NPI 1912439738

111 ALLEN ST
Netcong, NJ 07857

(973) 527-4464

✔ PECOS24 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 Archetype Psychological Services, LLC's NPI number?

The NPI number for Archetype Psychological Services, LLC is 1952964611. It was assigned to this organization in the NPPES registry on April 18, 2019.

Where is Archetype Psychological Services, LLC located?

Archetype Psychological Services, LLC is located at 444 Northfield Ave, West Orange, NJ 07052. The listed phone number is (646) 820-5477.

What is Archetype Psychological Services, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Archetype Psychological Services, LLC enrolled in Medicare?

Yes. Archetype Psychological Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Archetype Psychological Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Archetype Psychological Services, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Archetype Psychological Services, LLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Archetype Psychological Services, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Archetype Psychological Services, LLC was last updated on April 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.