Provider Demographics
NPI:1497081657
Name:LECYN-MOHLE, NORINE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:NORINE
Middle Name:E
Last Name:LECYN-MOHLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NORINE
Other - Middle Name:
Other - Last Name:MOHLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:231 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3108
Mailing Address - Country:US
Mailing Address - Phone:201-690-6412
Mailing Address - Fax:201-930-9842
Practice Address - Street 1:1172 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3936
Practice Address - Country:US
Practice Address - Phone:201-690-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100461000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist