Organization · Type 2 NPI

Mandala Integrative Therapy and Professional Development

Clinical Social Worker · Short Hills, NJ

NPI number 1104715556 Active

Practice location

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

Mailing address

484 Outlook Ave
Colonia, NJ 07067-3508

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104715556

Mandala Integrative Therapy and Professional Development's National Provider Identifier is 1104715556, issued on Jul 1, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Short Hills, NJ. The record was last updated on Jul 21, 2026.