Healthcare Provider Details

I. General information

NPI: 1134506025
Provider Name (Legal Business Name): CHECE PSYCHOLOGICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 04/01/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 KINGS HWY # 104
MIDDLETOWN NJ
07748-2509
US

IV. Provider business mailing address

18 KINGS HWY # 104
MIDDLETOWN NJ
07748-2509
US

V. Phone/Fax

Practice location:
  • Phone: 732-829-4654
  • Fax: 732-671-8704
Mailing address:
  • Phone: 732-671-8700
  • Fax: 732-671-8704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN DAVID CHECE
Title or Position: OWNER
Credential:
Phone: 732-829-4654