Active NPI
James Mandala, PH.D.
- Psychologist
- Newark, NJ
National Provider Identifier
1164750683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00275000
- Practice address
- New Jersey Institute of Technology
Drew University Counseling and Psychological Services
Newark, NJ 07940-1434 - Phone
- (973) 596-3415
- Fax
- (973) 408-3750
- NPI assigned
- Nov 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00275000 | NJ | |
| Psychologist | 103T00000X | 35SI00275000 | NJ | Primary |
Addresses
Primary practice location
New Jersey Institute of Technology
Drew University Counseling and Psychological Services
Newark, NJ 07940-1434
Mailing address
Campbell Hall 205
New Jersey Institute of Technology
Newark, NJ 07102
Phone (973) 596-3415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00275000 | NJ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drew University Health Service | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Student Health Clinic/Center
- Madison, NJ
- NPI 1366836462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1164750683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CAMPBELL HALL 205",
"address_2": "NEW JERSEY INSTITUTE OF TECHNOLOGY",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07102",
"telephone_number": "973-596-3415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NEW JERSEY INSTITUTE OF TECHNOLOGY",
"address_2": "DREW UNIVERSITY COUNSELING AND PSYCHOLOGICAL SERVICES",
"city": "NEWARK",
"state": "NJ",
"postal_code": "079401434",
"telephone_number": "973-596-3415",
"fax_number": "973-408-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDALA",
"first_name": "JAMES",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-20",
"last_updated": "2021-05-20",
"certification_date": "2021-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00275000",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00275000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.