Carrie Ditzel, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4937 Issued in NJ

Practice address

601 Flaghouse Dr
Hasbrouck Heights, NJ 07604-3118

Phone

(201) 381-6136

Fax

(201) 660-8271

NPI assigned

Feb 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Baker Street Behavioral HealthGroup PAC ID 3476945098, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baker Street Behavioral Health

  • Clinical Psychologist
  • Franklin Lakes, NJ
  • NPI 1659841096
  Medicare reassignment Care Compare group NPD
• Baker Street Mind Health, LLC

  • Psychiatry Physician
  • Paramus, NJ
  • NPI 1083488134
  NPD (past)

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1093983850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 FRANKLIN LAKE RD STE 204",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074172267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FLAGHOUSE DR",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076043118",
            "telephone_number": "201-381-6136",
            "fax_number": "201-660-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITZEL",
        "first_name": "CARRIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0174721",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "4937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Delaney, APN C
• Delcalzo Spine and Wellness Center
• Michael John Delgiodice, OD
• Michael Denichilo, LCSW
• Justin Anthony Dipisa, PHARMACIST
• Christina Dizzia
• Susan Eardley, RPH
• Rosemary Effah, PAN
• Todd D. Eglow, D.C.
• Kelsey Elbon

• Psychologist in Hasbrouck Heights, NJ
• Providers in Hasbrouck Heights, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.