Healthcare Provider Details

I. General information

NPI: 1164994257
Provider Name (Legal Business Name): SAMANTHA LINN DEFILIPPO PSY.D, NCSP, BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 MAIN ST STE 102
SPOTSWOOD NJ
08884-1703
US

IV. Provider business mailing address

3570 STATE ROUTE 27
KENDALL PARK NJ
08824-1049
US

V. Phone/Fax

Practice location:
  • Phone: 908-358-6064
  • Fax:
Mailing address:
  • Phone: 201-762-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35SI00788000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00009600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: