Healthcare Provider Details
I. General information
NPI: 1992668321
Provider Name (Legal Business Name): J&A PSYCHOLOGICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19 THAMES ROAD
POUGHKEEPSIE NY
12603
US
IV. Provider business mailing address
19 THAMES RD
POUGHKEEPSIE NY
12603-6832
US
V. Phone/Fax
- Phone: 585-615-9146
- Fax:
- Phone: 585-615-9146
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAYA
SAVE-MUNDRA
Title or Position: MANAGING MEMBER/AUTHORIZED OFFICIAL
Credential: PSYD
Phone: 585-615-9146