Anjelica Fahey
Individual provider Active NPI Psychologist · Cresskill, NJ
NPI 1497345201 · NPPES record last updated Mar 30, 2026
Key facts
- NPI
- 1497345201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- 300 Knickerbocker Rd Ste 2300a
Cresskill, NJ 07626-1345 - Phone
- (201) 297-9170
- NPI assigned
- Jan 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 2, 2026 through Apr 2, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Yes |
Addresses
Primary practice location
300 Knickerbocker Rd Ste 2300a
Cresskill, NJ 07626-1345
Mailing address
93 Walnut St
Oakland, NJ 07436-2616
Phone (201) 280-1679
Other practice location 1
239 Madison Ave
Wyckoff, NJ 07481-1948
Phone (201) 280-1679
Other providers in Cresskill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.