IndividualActive
Michelle Fanciullo, PSY.D.
NPI 1144831082 · Clinical Child & Adolescent Psychologist · Hackensack, NJ
Provider details
- NPI number
- 1144831082
- Entity type
- Individual
- Primary specialty
- Clinical Child & Adolescent PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 35SI00623300 (NJ)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
12 2nd St
Hackensack, NJ 07601-2009
Phone: (551) 996-8186
Approximate (ZIP-level) locationGet directions
Mailing address
30 Prospect Ave
Hackensack, NJ 07601-1915
Registry dates
- Enumerated
- 2020-08-13
- Last updated
- 2020-08-13
- Certified
- 2020-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.