Healthcare Provider Details

I. General information

NPI: 1194841494
Provider Name (Legal Business Name): WENDY TERRIE BEHARY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MILLBURN AVE SUITE 7-A
SPRINGFIELD NJ
07081-1039
US

IV. Provider business mailing address

28 MILLBURN AVE SUITE 7-A
SPRINGFIELD NJ
07081-1039
US

V. Phone/Fax

Practice location:
  • Phone: 973-218-1776
  • Fax: 973-376-7726
Mailing address:
  • Phone: 973-218-1776
  • Fax: 973-376-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00435200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: