Healthcare Provider Details

I. General information

NPI: 1891699419
Provider Name (Legal Business Name): ANNE WENNERSTRAND INTEGRATED PSYCHOTHERAPY, LCSW, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E MAIN ST STE 204
MOUNT KISCO NY
10549-3042
US

IV. Provider business mailing address

275 E MAIN ST STE 204
MOUNT KISCO NY
10549-3042
US

V. Phone/Fax

Practice location:
  • Phone: 646-334-2895
  • Fax: 646-530-6781
Mailing address:
  • Phone: 646-334-2895
  • Fax: 646-530-6781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANNE LORD WENNERSTRAND
Title or Position: OWNER/PRESIDENT
Credential: LCSW-R
Phone: 646-334-2895