Provider Demographics
NPI:1467688549
Name:MENDELSOHN, LEA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEA
Middle Name:
Last Name:MENDELSOHN
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 1:1311 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4202
Mailing Address - Country:US
Mailing Address - Phone:718-851-6100
Mailing Address - Fax:718-437-6654
Practice Address - Street 1:1311 55TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4202
Practice Address - Country:US
Practice Address - Phone:718-851-6100
Practice Address - Fax:718-437-6654
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075468-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool