Active NPI
Theresa Demichele, PHD
- Clinical Psychologist
- Marlboro, NJ
National Provider Identifier
1366280760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35S100752900
- Practice address
- 6 Orchard St
Marlboro, NJ 07746-1412 - Phone
- (650) 796-0922
- NPI assigned
- Jul 18, 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 | 35S100752900 | NJ | Primary |
Addresses
Primary practice location
6 Orchard St
Marlboro, NJ 07746-1412
Mailing address
6 Orchard St
Marlboro, NJ 07746-1412
Phone (650) 796-0922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100752900 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1366280760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 ORCHARD ST",
"city": "MARLBORO",
"state": "NJ",
"postal_code": "077461412",
"telephone_number": "650-796-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 ORCHARD ST",
"city": "MARLBORO",
"state": "NJ",
"postal_code": "077461412",
"telephone_number": "650-796-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMICHELE",
"first_name": "THERESA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-18",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35S100752900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.