Healthcare Provider Details

I. General information

NPI: 1013811215
Provider Name (Legal Business Name): WPF INTEGRATIVE PSYCHOTHERAPY LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CADMAN PLZ W FL 12
BROOKLYN NY
11201-3226
US

IV. Provider business mailing address

300 CADMAN PLZ W FL 12
BROOKLYN NY
11201-3226
US

V. Phone/Fax

Practice location:
  • Phone: 718-573-7028
  • Fax:
Mailing address:
  • Phone: 718-573-7028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. WALKENS PETIT-FRERE
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 718-573-7028