Organization Active NPI

Datchi Psychology and Consulting LLC

  • Psychologist
  • Summit, NJ
National Provider Identifier
1255708822
Registry record updated Aug 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00535000 Issued in NJ
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

Updated by the provider on Aug 30, 2015

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

Authorized official

Name
Dr. Corinne Cecile Datchi, PHD, ABPPNPI 1194108498
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)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 35SI00535000 NJ Primary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20151209001223 NJ Part B Supplier - Clinic/Group Practice 2860793213 Practice locations: Summit, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "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.

Verify at the official NPI Registry.