Provider Demographics
NPI:1841594629
Name:WYNBERG, WENDY (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:WENDY
Middle Name:
Last Name:WYNBERG
Suffix:
Gender:
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PARK DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1725
Mailing Address - Country:US
Mailing Address - Phone:845-532-3657
Mailing Address - Fax:
Practice Address - Street 1:5 PARK DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1725
Practice Address - Country:US
Practice Address - Phone:845-532-3657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-043435-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical