MEDICARE: CBT FOR ANXIETY AND OCD RELIEF, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist
2	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1093680548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CBT FOR ANXIETY AND OCD RELIEF, LLC

Provider Business Mailing Address
First Line	:	808 HIGH MOUNTAIN RD STE 201
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-2930
Country	:	US
Telephone Number	:	914-372-6779
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 HIGH MOUNTAIN RD STE 201
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-2930
Country	:	US
Telephone Number	:	914-372-6779
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL PSYCHOLOGIST
Name	:	DR. COURTNEY DEANGELIS
Credential	:	PSYD
Telephone Number	:	914-372-6779

Provider Enumeration Date	:	10/06/2025
Last Update Date	:	10/06/2025

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