NPIMap

Organization Active NPI

Opal DBT, LLC

  • Clinical Psychologist
  • Berwyn, PA
National Provider Identifier
1124859335
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OPAL DBT, LLC
Practice address
1171 Lancaster Ave Ste 100
Berwyn, PA 19312-2602
Phone
(484) 674-6325
Fax
(484) 674-6325
NPI assigned
Aug 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Dr. Nicole Daniella Chaikin, PSYDNPI 1962607010
Title
Owner/Psychologist
Phone
(484) 674-6324

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1171 Lancaster Ave Ste 100
Berwyn, PA 19312-2602

Mailing address

1171 Lancaster Ave Ste 100
Berwyn, PA 19312-2602
Phone (484) 674-6324

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1124859335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 LANCASTER AVE STE 100",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122602",
            "telephone_number": "484-674-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 LANCASTER AVE STE 100",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122602",
            "telephone_number": "484-674-6325",
            "fax_number": "484-674-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPAL DBT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "CHAIKIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DANIELLA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "484-674-6324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.