Provider Demographics
NPI:1427270461
Name:PRINCETON BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:PRINCETON BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-586-4788
Mailing Address - Street 1:21 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-1630
Mailing Address - Country:US
Mailing Address - Phone:609-397-5825
Mailing Address - Fax:609-587-7535
Practice Address - Street 1:1670 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3541
Practice Address - Country:US
Practice Address - Phone:609-586-4788
Practice Address - Fax:609-587-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health