MALLORY SEIDMAN (NPI# 1811304660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811304660 |
| Entity Type | Individual |
| Full Name | MALLORY SEIDMAN |
| Credential | PSY.D. |
| Practice Address |
16 Inness Pl Montclair NJ 07042-4923 |
| Practice Telephone | 9174267158 |
| Mailing Telephone | 9174267158 |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2020-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 35SI00571000 | NJ | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | 021231 | NY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
021231 | NY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
35SI00571000 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
16 INNESS PL |
| City | MONTCLAIR |
| State | NJ |
| Zip Code | 07042-4923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451261 | Montclair Art Museum | Voluntary or Charitable | 3 South Mountain Avenue, Montclair, NJ 07042 | 2019-11-12 |
| 1740847797 | Magnify In-home Eyecare | Optometrist | Little Nursing Home, 71 Christopher Street, Montclair, NJ 07042 | 2019-05-24 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1538666342 | Mary Elizabeth Mcgaughan | Psychologist | 239 Grove Street, Montclair, NJ 07042 | 2018-04-09 |
| 1023546777 | Alexander Scott Fisher | Dentist | 39 S Fullerton Ave Fl 2, Montclair, NJ 07042 | 2017-05-25 |
| 1942754825 | Kaity Rodriguez | Social Worker | 105 Grove St., Montclair, NJ 07042 | 2016-08-09 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1528413655 | Bellapianta Orthopaedics and Sports Medicine LLC | Orthopaedic Surgery | 1 Bay Avenue, Harries Pavilion, Suite 1, Montclair, NJ 07042 | 2016-04-26 |
| 1740647643 | Wendalyn Leona Browne | Massage Therapist | 37 Watchung Plaza, 2l, Montclair, NJ 07042 | 2016-01-22 |
| 1891168670 | Patience Moore | Social Worker | 460 Bloomfield Ave Ste 306, Montclair, NJ 07042 | 2015-11-03 |
| Find all providers in zip 07042 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679988703 | Erika Baron | Clinical Neuropsychologist | 516 Bloomfield Ave, Suite 3, Montclair, NJ 07042-3429 | 2014-06-27 |
| 1437127982 | Monica M Lintott | Clinical Neuropsychologist | 70 Park St, Suite 105, Montclair, NJ 07042-5907 | 2006-03-10 |
| 1285622217 | Jacqueline Ann Rondeau | Clinical Neuropsychologist | 70 Park St, Ste 207, Montclair, NJ 07042-2960 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437791993 | Dig It | Clinical Neuropsychologist | 5 Elm Ln, Rumson, NJ 07760-1001 | 2019-10-16 |
| 1255981767 | Brian Schopfer | Clinical Neuropsychologist | 792 Chimney Rock Rd Ste C, Martinsville, NJ 08836-2271 | 2019-09-17 |
| 1750866869 | Anjuli Bodapati | Clinical Neuropsychologist | 608 Sherwood Pkwy Ste 2d, Mountainside, NJ 07092 | 2018-09-25 |
| 1619496908 | Hilary F Murphy | Clinical Neuropsychologist | 1451 State Route 34 Ste 201, Wall Township, NJ 07727-1614 | 2017-09-18 |
| 1841653763 | Andrew P Brown IIi | Clinical Neuropsychologist | 31 Clinton St, Newark, NJ 07102-3729 | 2016-03-29 |
| 1053789230 | Lisa Hahn | Clinical Neuropsychologist | 916 Maple Ave, Newton, NJ 07860-4404 | 2015-09-04 |
| 1700264256 | Barbara Lauer Listhaus, Psy. D., LLC | Clinical Neuropsychologist | 513 W Mount Pleasant Ave Ste 210, Livingston, NJ 07039-1721 | 2015-05-15 |
| 1295128882 | Anne Romyr Denor | Clinical Neuropsychologist | 30 John St Apt 2c, Bloomfield, NJ 07003-5142 | 2015-03-06 |
| 1811325152 | Amy L. Hradil | Clinical Neuropsychologist | 2048 Oak Tree Road Center for Head Injuries, Cognitive Rehabilitation Progr, Edison, NJ 08820 | 2013-10-24 |
| 1295163046 | Diane Carbone | Clinical Neuropsychologist | 3429 Shoreline Dr, Allenwood, NJ 08720 | 2013-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.