Active NPI
Datchi Psychology and Consulting LLC
- Psychologist
- Summit, NJ
National Provider Identifier
1255708822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00535000
- Legal business name
- DATCHI PSYCHOLOGY AND CONSULTING LLC
- Practice address
- 35 Deforest Ave
Summit, NJ 07901-2155 - Phone
- (812) 360-5143
- NPI assigned
- Aug 30, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Corinne Cecile Datchi, PHD, ABPP
- Title
- Single Owner
- Phone
- (812) 360-5143
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35SI00535000 | NJ | Primary |
| Marriage & Family Therapist | 106H00000X | 35SI00535000 | NJ |
Addresses
Primary practice location
35 Deforest Ave
Summit, NJ 07901-2155
Mailing address
1480 Pleasant Valley Way
15
West Orange, NJ 07052-1300
Phone (812) 360-5143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151209001223 | NJ | Part B Supplier - Clinic/Group Practice | 2860793213 | Practice locations: Summit, NJ |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Summit, NJ
- NPI 1194108498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1440892800000",
"number": "1255708822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 PLEASANT VALLEY WAY",
"address_2": "15",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070521300",
"telephone_number": "812-360-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 DEFOREST AVE",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "079012155",
"telephone_number": "812-360-5143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DATCHI PSYCHOLOGY AND CONSULTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-30",
"last_updated": "2015-08-30",
"status": "A",
"authorized_official_last_name": "DATCHI",
"authorized_official_first_name": "CORINNE",
"authorized_official_middle_name": "CECILE",
"authorized_official_title_or_position": "SINGLE OWNER",
"authorized_official_telephone_number": "812-360-5143",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD, ABPP"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00535000",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "NJ",
"license": "35SI00535000",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Summit, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.