Healthcare Provider Details
I. General information
NPI: 1821989856
Provider Name (Legal Business Name): UD HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 DISCOVERY BLVD 6TH FLOOR, STAR TOWER
NEWARK DE
19713-1325
US
IV. Provider business mailing address
100 DISCOVERY BLVD STE 727
NEWARK DE
19713-1325
US
V. Phone/Fax
- Phone: 302-831-3000
- Fax:
- Phone: 302-831-2705
- Fax: 302-831-0367
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JED
CASTELLUCCI
Title or Position: CHIEF CLINICAL OPERATING OFFICER
Credential:
Phone: 302-831-2705