Provider Demographics
NPI:1538883780
Name:WELLNESS PSYCHOTHERAPY SERVICES LINDA BEDERMAN LCSW PLLC
Entity type:Organization
Organization Name:WELLNESS PSYCHOTHERAPY SERVICES LINDA BEDERMAN LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-679-6528
Mailing Address - Street 1:9850 67TH AVE APT 3H
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4957
Mailing Address - Country:US
Mailing Address - Phone:917-679-6528
Mailing Address - Fax:
Practice Address - Street 1:7210 112TH ST OFC B
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5467
Practice Address - Country:US
Practice Address - Phone:917-679-6528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty