Provider Demographics
NPI:1023190253
Name:BENDET, BILLA TESSLER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BILLA
Middle Name:TESSLER
Last Name:BENDET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4740
Mailing Address - Country:US
Mailing Address - Phone:718-692-4372
Mailing Address - Fax:718-677-5909
Practice Address - Street 1:1273 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3820
Practice Address - Country:US
Practice Address - Phone:718-435-5700
Practice Address - Fax:718-854-5495
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04503-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9A611Medicare ID - Type UnspecifiedLCSW