Provider Demographics
NPI:1669667754
Name:WANDEL, BELINDA NELLIE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:NELLIE
Last Name:WANDEL
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 E MAIN STREET RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3496
Mailing Address - Country:US
Mailing Address - Phone:585-344-1421
Mailing Address - Fax:585-345-3080
Practice Address - Street 1:11 BATAVIA CITY CENTRE
Practice Address - Street 2:BATAVIA COMMUNITY CARE CENTER
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-344-4246
Practice Address - Fax:585-344-4895
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0743121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05333404Medicaid
NY5717300OtherCIGNA
NY12463317OtherEXCELLUS
NYJ300490154OtherMEDICARE