Provider Demographics
NPI:1235355769
Name:LIFESPAN PSYCHOLOGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LIFESPAN PSYCHOLOGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-444-0090
Mailing Address - Street 1:615 FRANKLIN TPKE STE 1
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1903
Mailing Address - Country:US
Mailing Address - Phone:201-444-0090
Mailing Address - Fax:201-444-1566
Practice Address - Street 1:615 FRANKLIN TPKE STE 1
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1903
Practice Address - Country:US
Practice Address - Phone:201-444-0090
Practice Address - Fax:201-444-1566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty