Provider Demographics
NPI:1487820759
Name:MENDELSON, MARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:MENDELSON
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 1:144 W 12TH ST
Mailing Address - Street 2:REISS 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-8206
Mailing Address - Fax:212-604-8212
Practice Address - Street 1:144 W 12TH ST
Practice Address - Street 2:REISS 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8206
Practice Address - Fax:212-604-8212
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR023140-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical