Individual provider Active NPI

Meredith Dedilectis, PSYD

  • Clinical Child & Adolescent Psychologist
  • Chatham, NJ
National Provider Identifier
1982079760
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
35SI00752300 Issued in NJ
Practice address
466 Southern Blvd
Chatham, NJ 07928-1462
Phone
(973) 370-9944
Fax
(973) 813-7065
NPI assigned
Dec 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00752300 NJ
Forensic Psychologist 103TF0200X 35SI00752300 NJ
Clinical Child & Adolescent Psychologist 103TC2200X 35SI00752300 NJ Primary

Addresses

Primary practice location

466 Southern Blvd
Chatham, NJ 07928-1462

Mailing address

466 Southern Blvd
Chatham, NJ 07928-1462
Phone (973) 370-9944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35SI00752300NJMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1449273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1982079760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 SOUTHERN BLVD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281462",
            "telephone_number": "973-370-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 SOUTHERN BLVD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281462",
            "telephone_number": "973-370-9944",
            "fax_number": "973-813-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDILECTIS",
        "first_name": "MEREDITH",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-05",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00752300",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NJ",
            "license": "35SI00752300",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00752300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.