Provider Demographics
NPI:1740437102
Name:EVERS-VELAZQUEZ, WENDY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:EVERS-VELAZQUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:EVERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4209 28TH ST # CN-48
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:347-396-6299
Mailing Address - Fax:347-396-6367
Practice Address - Street 1:295 FLATBUSH AVENUE EXT FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3001
Practice Address - Country:US
Practice Address - Phone:347-396-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099396104100000X
NY0977211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker