Provider Demographics
NPI:1972274322
Name:WECHSLER, KATHRYN (MHC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 CARVER LOOP APT 20D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-2953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1231 LAFAYETTE AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5367
Practice Address - Country:US
Practice Address - Phone:718-635-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010627-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health