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STATE OF DELAWARE

Health Service

A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).

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Contact Information

STATE OF DELAWARE
417 FEDERAL ST
DOVER, DE  19901-3635
 Phone: 302-744-4548
 Fax: 302-739-1613
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Health Service

 103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for STATE OF DELAWARE

NPI Number 1306918180
LBN Legal business name STATE OF DELAWARE
Authorized official KARYL RATTAY - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2006
Last updated 12/01/2011 - About 15 years ago
Identifiers
DE Medicaid 0000300957
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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