Provider Demographics
NPI:1336493980
Name:MAYER, MINDY (LCSW-R)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BANK ST
Mailing Address - Street 2:116J
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1917
Mailing Address - Country:US
Mailing Address - Phone:914-924-3390
Mailing Address - Fax:
Practice Address - Street 1:15 BANK ST
Practice Address - Street 2:116J
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1917
Practice Address - Country:US
Practice Address - Phone:914-924-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO28828-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health