Healthcare Provider Details

I. General information

NPI: 1003692377
Provider Name (Legal Business Name): DR DEL PSYCHOTHERAPY IN PRINCETON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 09/04/2023
Certification Date: 09/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 NASSAU ST
PRINCETON NJ
08542-7011
US

IV. Provider business mailing address

8 PENZIAS PL
HIGHLAND PARK NJ
08904-1677
US

V. Phone/Fax

Practice location:
  • Phone: 917-576-1544
  • Fax:
Mailing address:
  • Phone: 917-576-1544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DELVERLON HALL
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 917-576-1544