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

Mandala Integrative Therapy and Professional Development

Organization Clinical Social Worker · NPI 1104715556

Mandala Integrative Therapy and Professional Development is a Clinical Social Worker in Short Hills, New Jersey. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

514 Millburn Ave # 2009
Short Hills, NJ 07078-2508
Phone: (908) 460-8003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1104715556
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacqueline Crocker — Owner · (908) 460-8003
NPI enumeratedJuly 1, 2025
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026
Mailing address484 Outlook Ave, Colonia, NJ 07067-3508

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