ANTOINETTE COOPER TATE (PHD) – Psychologist, NPI 1417181850

ANTOINETTE COOPER TATE (PHD) is a healthcare provider. based in Moorestown, New Jersey. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 35SI00544600 (NJ). The NPI Number for ANTOINETTE COOPER TATE (PHD) is 1417181850

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
ANTOINETTE COOPER TATE (PHD)
NPI
1417181850
Phone
(856) 722-9043
Address
720 E MAIN ST STE 1A
Enumeration Date
13 May 2009
Last Update Date
1 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8567229043
Graduation Year
2010 (16 years ago)
PAC ID
2062764335
Group Practice PAC ID
7416205232
Professional Enrollment ID
I20181015002724
Address ID
NJ080573058MO720XXSTXX403
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:17State licenses:1Digital endpointsOther names

963 CLINICAL PSYCHOLOGIST in NJ

Provider Addresses for ANTOINETTE COOPER TATE (PHD)

  • 720 E MAIN ST STE 1A

    MOORESTOWN, NJ 080573058

    Phone: (856) 722-9043

    Fax: (856) 727-1715

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-10-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181015002724IClinical PsychologistNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08057)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416205232View full group profile
NameSpecialtyState
Mental Health CounselorNJ
-NJ
Clinical PsychologistNJ
Clinical Social WorkerNJ
Clinical PsychologistNJ
Clinical Social WorkerNJ
Clinical Social WorkerNJ

Reviews

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Frequently asked questions

Can I cross-check ANTOINETTE COOPER TATE (PHD) using NPI 1417181850?
NPI 1417181850 belongs to ANTOINETTE COOPER TATE (PHD); compare other details if you need extra assurance.
Is ANTOINETTE COOPER TATE (PHD) shown as active in public data?
Registry records indicate ANTOINETTE COOPER TATE (PHD) maintains an active NPI.
What expertise is attributed to ANTOINETTE COOPER TATE (PHD)?
ANTOINETTE COOPER TATE (PHD)'s specialty line reads Psychologist. Clinical services aligned with this taxonomy classification.
Is ANTOINETTE COOPER TATE (PHD) located near Moorestown?
ANTOINETTE COOPER TATE (PHD) currently maps to Moorestown, New Jersey in this extract.
Can I trust this NPI listing for ANTOINETTE COOPER TATE (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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