NPIMap

Organization Active NPI

Duckett & Charleston Psychological Associates, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Laurel, NJ
National Provider Identifier
1053000489
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DUCKETT & CHARLESTON PSYCHOLOGICAL ASSOCIATES, LLC
Practice address
3221 Route 38 Ste 201
Mount Laurel, NJ 08054-9765
Phone
(609) 251-6947
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda M Coinbert
Title
Office Manager
Phone
(609) 251-6947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3221 Route 38 Ste 201
Mount Laurel, NJ 08054-9765

Mailing address

3221 Route 38 Ste 201
Mount Laurel, NJ 08054-9765
Phone (609) 251-6947

National Provider Directory

National Provider Directory
Tax ID family
Duckett Charleston Psychological Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1053000489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 ROUTE 38 STE 201",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549765",
            "telephone_number": "609-251-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 ROUTE 38 STE 201",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549765",
            "telephone_number": "609-251-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUCKETT & CHARLESTON PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "COINBERT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "609-251-6947"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.