Provider Demographics
NPI:1780833111
Name:DEBORAH SCIMECA-DIAZ, LLC
Entity Type:Organization
Organization Name:DEBORAH SCIMECA-DIAZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIMECA-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LCADC
Authorized Official - Phone:609-915-9387
Mailing Address - Street 1:22 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1223
Mailing Address - Country:US
Mailing Address - Phone:609-915-9387
Mailing Address - Fax:
Practice Address - Street 1:22 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1223
Practice Address - Country:US
Practice Address - Phone:609-915-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00158100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health