| Datchi Psychology And Consulting Llc | |
|
35 Deforest Ave Summit NJ 07901-2155 | |
| (812) 360-5143 | |
| Not Available |
| Full Name | Datchi Psychology And Consulting Llc |
|---|---|
| Speciality | Psychologist |
| Location | 35 Deforest Ave, Summit, New Jersey |
| Authorized Official Name and Position | Corinne Cecile Datchi (SINGLE OWNER) |
| Authorized Official Contact | 8123605143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Datchi Psychology And Consulting Llc 1480 Pleasant Valley Way 15 West Orange NJ 07052-1300 Ph: (812) 360-5143 | Datchi Psychology And Consulting Llc 35 Deforest Ave Summit NJ 07901-2155 Ph: (812) 360-5143 |
| NPI Number | 1255708822 |
|---|---|
| Provider Enumeration Date | 08/30/2015 |
| Last Update Date | 08/30/2015 |
| Medicare PECOS PAC ID | 2860793213 |
|---|---|
| Medicare Enrollment ID | O20151209001223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255708822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35SI00535000 (New Jersey) | Primary |
| 106H00000X | Marriage & Family Therapist | 35SI00535000 (New Jersey) | Secondary |
| Provider Name | Corinne Cecile Datchi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194108498 PECOS PAC ID: 3779884127 Enrollment ID: I20151209001415 |
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