Jonathan H. Mack, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35SI00232100 Issued in NJ

Practice address

800 Denow Rd Ste S
Pennington, NJ 08534-5246

Phone

(609) 890-8844

Fax

(609) 890-8817

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Forensic Psychology & Neuropsychology Services,P.C.

  • Psychologist
  • Pennington, NJ
  • NPI 1548323371
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1346303161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DENOW RD STE S",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085345246",
            "telephone_number": "609-890-8844",
            "fax_number": "609-890-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 DENOW RD STE S",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085345246",
            "telephone_number": "609-890-8844",
            "fax_number": "609-890-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JONATHAN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "S102321",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00232100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Jon Lundquist, MSW, LCSW
• Laura Sue Lurie, MSW, LCSW
• Kaitlin Lynch, APN
• Nina Lynch, NP
• Tyler Michael Macdonald, MOT, OTR/L
• Kelly Maguire, CCC-SLP
• Pavani Mahadass, MD
• Pamela Maisey, DO
• Jenna Mancinelli, D.O.
• Alicia McKenzie Mangin, MPH, PA-C

• Clinical Neuropsychologist in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.