Provider Demographics
NPI:1992917629
Name:PEELE, STANTON (PHD)
Entity type:Individual
Prefix:DR
First Name:STANTON
Middle Name:
Last Name:PEELE
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 1:19E KENSINGTON RD.
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2929
Mailing Address - Country:US
Mailing Address - Phone:973-387-0475
Mailing Address - Fax:
Practice Address - Street 1:19 KENSINGTON RD APT E
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2929
Practice Address - Country:US
Practice Address - Phone:973-387-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00136800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist