Provider Demographics
NPI:1215540166
Name:IMMANUEL INSTITUTE OF PSYCHOLOGY
Entity Type:Organization
Organization Name:IMMANUEL INSTITUTE OF PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SINCHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCDUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-559-4497
Mailing Address - Street 1:16192 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-3608
Mailing Address - Country:US
Mailing Address - Phone:302-559-4497
Mailing Address - Fax:
Practice Address - Street 1:16192 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3608
Practice Address - Country:US
Practice Address - Phone:302-559-4497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty