Provider Demographics
NPI:1760160428
Name:MENDELSON, LEAH (LMSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MENDELSON
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 1:457 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7133
Mailing Address - Country:US
Mailing Address - Phone:901-734-3326
Mailing Address - Fax:
Practice Address - Street 1:16 MADISON SQ W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1627
Practice Address - Country:US
Practice Address - Phone:856-671-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113894104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker