Provider Demographics
NPI:1255503595
Name:PAULINO, WENDY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:PAULINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LMSW
Mailing Address - Street 1:1727 AMSTERDAM AVENUE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031
Mailing Address - Country:US
Mailing Address - Phone:212-862-0054
Mailing Address - Fax:212-862-5516
Practice Address - Street 1:1727 AMSTERDAM AVENUE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031
Practice Address - Country:US
Practice Address - Phone:212-862-0054
Practice Address - Fax:212-862-5516
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY0808291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker