Active NPI
Jennifer Mahfouz, PSYD
- Psychologist
- Sparta, NJ
National Provider Identifier
1659158731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00707100
- Practice address
- 10 Arrowhead TRL
Sparta, NJ 07871-1731 - Phone
- (973) 975-6830
- NPI assigned
- Sep 12, 2023
- Last updated
- Sep 12, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35SI00707100 | NJ | Primary |
Addresses
Primary practice location
10 Arrowhead TRL
Sparta, NJ 07871-1731
Mailing address
10 Arrowhead TRL
Sparta, NJ 07871-1731
Phone (973) 975-6830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 18, 2023 through Oct 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00707100 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1659158731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 ARROWHEAD TRL",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078711731",
"telephone_number": "973-975-6830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 ARROWHEAD TRL",
"city": "SPARTA",
"state": "NJ",
"postal_code": "078711731",
"telephone_number": "973-975-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHFOUZ",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00707100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.