Healthcare Provider Details

I. General information

NPI: 1255407698
Provider Name (Legal Business Name): PIKE CREEK PSYCHOLOGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 POLLY DRUMMOND HILL RD
NEWARK DE
19711-5703
US

IV. Provider business mailing address

8 POLLY DRUMMOND HILL RD
NEWARK DE
19711-5703
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-6859
  • Fax: 302-368-5309
Mailing address:
  • Phone: 302-738-6859
  • Fax: 302-368-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JD WILLETTS II
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 302-738-6859