Provider Demographics
NPI:1609944537
Name:KAISER, WENDY S (LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:S
Last Name:KAISER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E 12TH ST
Mailing Address - Street 2:SUITE 16C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5008
Mailing Address - Country:US
Mailing Address - Phone:212-228-0323
Mailing Address - Fax:
Practice Address - Street 1:77 E 12TH ST
Practice Address - Street 2:SUITE 16C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5002
Practice Address - Country:US
Practice Address - Phone:212-228-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027065-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN28181Medicare ID - Type Unspecified