Provider Demographics
NPI:1093919987
Name:HOLNESS, WENDY JEANETTE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:JEANETTE
Last Name:HOLNESS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 DE REIMER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1820
Mailing Address - Country:US
Mailing Address - Phone:718-325-5297
Mailing Address - Fax:
Practice Address - Street 1:4119 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3007
Practice Address - Country:US
Practice Address - Phone:718-652-0227
Practice Address - Fax:718-652-9275
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067635104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker