David Cancell, MA
Individual provider Active NPI Clinical Psychologist · Millburn, NJ
NPI 1295864528 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1295864528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 686 (NJ)
- Practice address
- 236 Glen Ave
Millburn, NJ 07041-1620 - Phone
- (973) 379-4370
- NPI assigned
- Mar 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 686 | NJ | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 686 | NJ | Yes |
Addresses
Primary practice location
236 Glen Ave
Millburn, NJ 07041-1620
Mailing address
236 Glen Ave
Millburn, NJ 07041-1620
Phone (973) 379-4370
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All providers in Millburn, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.