Individual provider Active NPI

Dalia Lightman, PSYD

  • Clinical Psychologist
  • Teaneck, NJ
National Provider Identifier
1548628373
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00552500 Issued in NJ
Practice address
572 Cumberland Ave
Teaneck, NJ 07666-2651
Phone
(201) 578-7831
NPI assigned
Feb 8, 2016
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00552500 NJ Primary

Addresses

Primary practice location

572 Cumberland Ave
Teaneck, NJ 07666-2651

Mailing address

572 Cumberland Ave
Teaneck, NJ 07666-2651
Phone (201) 692-0942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160304001010 NJ Practitioner - Clinical Psychologist 3577869320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

572 Cumberland Ave
Teaneck, NJ 07666-2651
Phone (201) 692-0942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00552500NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Story of Life Therapy LLC CurrentSince Nov 19, 2015 Accepting new patients

Locations

121 Cedar Ln
Teaneck, NJ 07666
Phone (201) 294-7445

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1548628373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 CUMBERLAND AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662651",
            "telephone_number": "201-692-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 CUMBERLAND AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662651",
            "telephone_number": "201-578-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTMAN",
        "first_name": "DALIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00552500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.