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General NPI Number Information
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NPI Number | 1225504582
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Entity Type | Individual
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Provider Name | WENDI JILL REDNICK LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 19 W 34TH ST RM 1200
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 800-627-5717
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BANK ST APT 120D
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City | WHITE PLAINS
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State | NY
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Zip | 10606-1988
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Country | US
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Telephone | 347-759-8337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 054624
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License Number State | NY
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