=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336071810
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES N MASCIALE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2026
-----------------------------------------------------
Last Update Date | 06/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6603 FRESH POND RD FL 1
-----------------------------------------------------
City | RIDGEWOOD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11385-3310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-227-8334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6603 FRESH POND RD FL 1
-----------------------------------------------------
City | RIDGEWOOD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11385-3310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-227-8334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | P141431
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------