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General NPI Number Information
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NPI Number | 1306603857
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Entity Type | Organization
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Legal Business Name | THE DIASPORA PSYCHOLOGIST, LLC
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 13 N MAIN ST
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City | CRANBURY
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State | NJ
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Zip | 08512-3255
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Country | US
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Telephone | 732-875-0985
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Fax | 888-244-7140
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | CRANBURY
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State | NJ
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Zip | 08512-0130
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Country | US
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Telephone | 732-501-3449
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Fax | 888-244-7140
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Authorized Official
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Title or Position | OWNER
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Name | SHIRIN ZARQA-LEDERMAN
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Credential | LPC
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Telephone | 732-501-3449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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