Provider Demographics
NPI:1922407816
Name:PRINCETON PSYCHOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PRINCETON PSYCHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:609-250-2567
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE C20-A
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-250-2567
Mailing Address - Fax:
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE C20-A
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-250-2567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00531400261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health