Mindset Psychotherapy Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL05548300 Issued in NJ

Legal business name

MINDSET PSYCHOTHERAPY CENTER

Practice address

2040 Millburn Ave. Suite 205
Maplewood, NJ 07040

Phone

(201) 207-7268

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Ivey Prusiowski, LCSW

Title

Director

Phone

(201) 207-7268

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1548717143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE. SUITE 205",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "201-207-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MILLBURN AVE. SUITE 205",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "07040",
            "telephone_number": "201-207-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSET PSYCHOTHERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "IVEY PRUSIOWSKI",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-207-7268",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05548300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Milgrom
• Millburn Medical Imaging, PA
• Cheron Darlene Miller Roche, OT/L
• Catherine Lillianne Miller, DO
• Mind Your Thoughts
• Sevil H Modeste
• Erlie Moise, LAC
• Randi Morgan, RN
• Niama Morrison, MSW
• Ralph Moscarella, MA, CCC-A

• Clinical Social Worker in Maplewood, NJ
• Providers in Maplewood, 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 Sep 1, 2016; 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.