Provider Demographics
NPI:1831312388
Name:HOUSER-PUSCHEL, MANDI C (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:MANDI
Middle Name:C
Last Name:HOUSER-PUSCHEL
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1009
Mailing Address - Country:US
Mailing Address - Phone:856-845-8050
Mailing Address - Fax:
Practice Address - Street 1:13 W ORMOND AVE
Practice Address - Street 2:C2
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3041
Practice Address - Country:US
Practice Address - Phone:856-332-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00393200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional