Provider Demographics
NPI:1629316187
Name:LAUBER, WENDY A (LCSWR)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:LAUBER
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 AVENUE W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5202
Mailing Address - Country:US
Mailing Address - Phone:866-569-7233
Mailing Address - Fax:718-336-6815
Practice Address - Street 1:255 AVENUE W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5202
Practice Address - Country:US
Practice Address - Phone:866-569-7233
Practice Address - Fax:718-336-6815
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045634R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical