Healthcare Provider Details

I. General information

NPI: 1679044028
Provider Name (Legal Business Name): THE MINDFUL PATH TO PSYCHOLOGICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LINCOLN AVE
RUTHERFORD NJ
07070-2186
US

IV. Provider business mailing address

9 LINCOLN AVE
RUTHERFORD NJ
07070-2186
US

V. Phone/Fax

Practice location:
  • Phone: 201-500-2068
  • Fax:
Mailing address:
  • Phone: 201-500-2068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL MAHONEY RENGIFO
Title or Position: PSYCHOLOGIST/OWNER
Credential: PHD
Phone: 201-500-2068