Provider Demographics
NPI:1750140232
Name:LAITUSIS, CARA CAHALAN (PHD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:CAHALAN
Last Name:LAITUSIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:JEAN
Other - Last Name:CAHALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 E WELLING AVE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3321
Mailing Address - Country:US
Mailing Address - Phone:609-540-8828
Mailing Address - Fax:
Practice Address - Street 1:100 STRAUBE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1468
Practice Address - Country:US
Practice Address - Phone:609-797-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00743400103G00000X, 103TB0200X, 103TM1800X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities