Provider Demographics
NPI:1861526543
Name:MUCH, MANDELL J (PHD)
Entity type:Individual
Prefix:DR
First Name:MANDELL
Middle Name:J
Last Name:MUCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 NORRIS RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4516
Mailing Address - Country:US
Mailing Address - Phone:302-634-0322
Mailing Address - Fax:
Practice Address - Street 1:109 NORRIS RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4516
Practice Address - Country:US
Practice Address - Phone:302-634-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB10000326103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000030242Medicaid