Provider Demographics
NPI:1639318876
Name:MENDEL, ALIZA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:MENDEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ALIZA
Other - Middle Name:
Other - Last Name:MENDEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2 FESSLER PL.
Mailing Address - Street 2:#2
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042
Mailing Address - Country:US
Mailing Address - Phone:917-710-2840
Mailing Address - Fax:
Practice Address - Street 1:19 W. 34TH ST.
Practice Address - Street 2:
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:917-710-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730739521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical