Mandala Integrative Therapy and Professional Development

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MANDALA INTEGRATIVE THERAPY AND PROFESSIONAL DEVELOPMENT

Practice address

514 Millburn Ave # 2009
Short Hills, NJ 07078-2508

Phone

(908) 460-8003

NPI assigned

Jul 1, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacqueline Crocker, LCSWNPI 1538547948

Title

Owner

Phone

(908) 460-8003

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Crocker, LCSW

  • Clinical Social Worker
  • Short Hills, NJ
  • NPI 1538547948
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1104715556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 OUTLOOK AVE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070673508",
            "telephone_number": "908-460-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 MILLBURN AVE # 2009",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782508",
            "telephone_number": "908-460-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDALA INTEGRATIVE THERAPY AND PROFESSIONAL DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-01",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-460-8003",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tamara Maitlin
• Caryn Mandel, LCSW
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• Alyssa Brooke Matthews, PT, DPT
• Sweeti Mehra, M.D.

• Clinical Social Worker in Short Hills, NJ
• Providers in Short Hills, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.