Provider Demographics
NPI:1316082019
Name:BRANDT, JAMES DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:BRANDT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428A BARTON RUN BLVD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2732
Mailing Address - Country:US
Mailing Address - Phone:856-985-1003
Mailing Address - Fax:
Practice Address - Street 1:765 E ROUTE 70
Practice Address - Street 2:BUILDING A, CENTER FOR FAMILY GUIDANCE
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-983-3900
Practice Address - Fax:856-210-2019
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100169300103TC0700X
NJ35SI00196300103TF0000X, 103TF0200X, 103TH0100X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral