Active NPI
Megan Deriso, PSYD
- Clinical Psychologist
- Princeton, NJ
National Provider Identifier
1174357743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00756400
- Practice address
- 601 Ewing St.
Suite C-2
Princeton, NJ 08540 - Phone
- (856) 220-9672
- NPI assigned
- Aug 27, 2024
- Last updated
- Aug 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00756400 | NJ | Primary |
Addresses
Primary practice location
601 Ewing St.
Suite C-2
Princeton, NJ 08540
Mailing address
601 Ewing St.
Suite C-2
Princeton, NJ 08540
Phone (856) 220-9672
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 23, 2025 through Jul 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00756400 | NJ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorative Therapy Center of New Jersey | Clinical | Current | Accepting new patients |
| The Center for Emotional Health of Greater Philadelphia, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Jersey City, NJ
- NPI 1174477038
-
- Clinical Psychologist
- Cherry Hill, NJ
- NPI 1679807531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1174357743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 EWING ST.",
"address_2": "SUITE C-2",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "08540",
"telephone_number": "856-220-9672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 EWING ST.",
"address_2": "SUITE C-2",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "08540",
"telephone_number": "856-220-9672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERISO",
"first_name": "MEGAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-27",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00756400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, NJ
- Dineen Denkovic, RDN
- Sonia Deora, D.O.
- Department of Physical Medicine and Rehab
- Emily Deppe, PHARMD
- Dept. of Med, C/O Carl O'Brien Dba Princeton Hosp. Medical Assocs.
- Derma Sciences, Inc
- Dermatology & Skin Surgery Center of Princeton LLC
- Dermatology Institute of Princeton LLC
- Padma Desai, M.A.
- Urvi Desai
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.