Provider Demographics
NPI:1689070708
Name:WECHSLER, NATHALIE (LMSW)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 5TH AVE APT 6D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8006
Mailing Address - Country:US
Mailing Address - Phone:917-373-1618
Mailing Address - Fax:
Practice Address - Street 1:171 MADISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5153
Practice Address - Country:US
Practice Address - Phone:212-889-4042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093234-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical