Provider Demographics
NPI:1215177662
Name:MISCHEL, REBECCA ELISA (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ELISA
Last Name:MISCHEL
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STATE ST
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5200
Mailing Address - Country:US
Mailing Address - Phone:201-357-7179
Mailing Address - Fax:
Practice Address - Street 1:100 STATE ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5200
Practice Address - Country:US
Practice Address - Phone:201-357-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist