PDP Associates LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PDP ASSOCIATES LLC

Practice address

3490 US Highway 1
Building 16 Suite 112
Princeton, NJ 08540

Phone

(732) 479-1519

NPI assigned

Apr 9, 2019

Organization subpart

No

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

Authorized official

Name

Poonam Patel, LPCNPI 1417451725

Title

Owner

Phone

(732) 479-1519

Specialties & licenses 2

Addresses

Other names 1

• Phoenix Wellness Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Poonam D Patel, LPC

  • Professional Counselor
  • Princeton, NJ
  • NPI 1417451725
  NPD Authorized official
• Amanda Christine Cusa, LSW

  • Social Worker
  • Princeton, NJ
  • NPI 1972109692
  NPD

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1700349552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BEAUMONT PL",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080606729",
            "telephone_number": "732-986-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 US HIGHWAY 1",
            "address_2": "BUILDING 16 SUITE 112",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "732-479-1519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Atrium Way",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080543909",
            "country_code": "US",
            "telephone_number": "732-479-1519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Farber Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "NJ",
            "postal_code": "085405913",
            "country_code": "US",
            "telephone_number": "732-479-1519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PDP ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "POONAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-479-1519",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Marc Paul, DC
• Sima Christina Paul, M.D.
• Susan Paul, LCSW
• Pavilions at Forrestal
• Diandra Kathleen Pavlosky, LCSW
• Ivy L Pearlstein, APN-C
• Kellan Peck, LSW
• Rhea Amruta Peddinti, LAC
• Anne Marie Pellegrino, LAC
• Marissa Nicole Pellegrino, PH.D.

• Professional Counselor in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.