Provider Demographics
NPI:1972985729
Name:MANDEL, MARSHA E (LMHC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:E
Last Name:MANDEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 FULLERTON AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3740
Mailing Address - Country:US
Mailing Address - Phone:845-458-8288
Mailing Address - Fax:845-913-9048
Practice Address - Street 1:372 FULLERTON AVE STE 13
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3740
Practice Address - Country:US
Practice Address - Phone:845-458-8288
Practice Address - Fax:845-913-9048
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health