Provider Demographics
NPI:1275070914
Name:S. JAKOB MAHLER PSYCHOLOGY GROUP LLC
Entity Type:Organization
Organization Name:S. JAKOB MAHLER PSYCHOLOGY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHILOSOPHY
Authorized Official - Prefix:
Authorized Official - First Name:SENYA
Authorized Official - Middle Name:JAKOB
Authorized Official - Last Name:MAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-873-6698
Mailing Address - Street 1:3-07 LINDEN LN
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4826
Mailing Address - Country:US
Mailing Address - Phone:201-873-6698
Mailing Address - Fax:
Practice Address - Street 1:3-07 LINDEN LN
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4826
Practice Address - Country:US
Practice Address - Phone:201-873-6698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100558400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty