Healthcare Provider Details

I. General information

NPI: 1932024429
Provider Name (Legal Business Name): NATHAN FEHNEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 KENNEDY RD SUITE 39A
ANDOVER NJ
07821
US

IV. Provider business mailing address

502 E VALLEY VIEW AVE
HACKETTSTOWN NJ
07840-1416
US

V. Phone/Fax

Practice location:
  • Phone: 862-284-7187
  • Fax:
Mailing address:
  • Phone: 610-248-3347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number37AC00961600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: