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General NPI Number Information
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NPI Number | 1720034150
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Entity Type | Individual
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Provider Name | WENDY FLEMING LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 939 JOHNSON AVE
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City | RONKONKOMA
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State | NY
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Zip | 11779-6066
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Country | US
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Telephone | 631-471-7242
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Fax | 631-738-0427
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Provider Business Mailing Address
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Address Line | 49 CHARLES RD
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-6227
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Country | US
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Telephone | 631-471-7242
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Fax | 631-738-0427
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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 | R015231
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License Number State | NY
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