Provider Demographics
NPI:1306137245
Name:MANDEL, LINDA ANN (LMHC, CRC, PHD, SPSY)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:MANDEL
Suffix:
Gender:F
Credentials:LMHC, CRC, PHD, SPSY
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:MANDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC,CRC, PHD, SPSY
Mailing Address - Street 1:3 ASH CT APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3746
Mailing Address - Country:US
Mailing Address - Phone:845-216-4420
Mailing Address - Fax:845-875-9865
Practice Address - Street 1:3 ASH CT
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3746
Practice Address - Country:US
Practice Address - Phone:845-216-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374500367800101YP2500X
NJ561640103TS0200X
NY001928-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
11733138OtherCAQH