Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqueline Shall-McCumiskey, PSYD Mindful Practice

Organization Psychologist · NPI 1104699974

Jacqueline Shall-McCumiskey, PSYD Mindful Practice is a Psychologist in Staten Island, New York. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1675 Richmond Rd
Staten Island, NY 10304-2317
Phone: (646) 479-8068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X

Record details

NPI number1104699974
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organization1104699974
Authorized official Jacqueline Shall-McCumiskey — Owner · (646) 479-8068
Other names Jacqueline Shall-McCumiskey, Psy.D., Pllc; Jacqueline Shall-McCumiskey, Psy.D., Pllc; Jacqueline Shall-McCumiskey, Psy.D. Mindful Practice
NPI enumeratedNovember 3, 2023
Last updated in NPPESMarch 3, 2025
Certification dateFebruary 6, 2025
Mailing address1675 Richmond Rd, Staten Island, NY 10304-2317

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