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General NPI Number Information
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NPI Number | 1528877925
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Entity Type | Individual
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Provider Name | CHAIM MANDEL LSW-NJ, LMSW-NY
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Gender | Male
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Dates
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Enumeration Date | 01/01/2025
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 500 W KENNEDY BLVD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1254
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Country | US
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Telephone | 732-901-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 450 W KENNEDY BLVD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1269
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Country | US
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Telephone | 732-886-6964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07196900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 125313
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License Number State | NY
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