Provider Demographics
NPI:1528185691
Name:COLE-WENDERLICH, DEBORAH (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:COLE-WENDERLICH
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:4129 ONNALINDA DR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8231
Mailing Address - Country:US
Mailing Address - Phone:585-394-4627
Mailing Address - Fax:
Practice Address - Street 1:603 W WASHINGTON ST
Practice Address - Street 2:FINGER LAKES MIGRANT COMMUNITY HEALTH
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-2119
Practice Address - Country:US
Practice Address - Phone:315-781-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01635211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR0163521OtherNYS LICENSE