Provider Demographics
NPI:1548346927
Name:WINOGRAD, WENDY (LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:WINOGRAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 WESTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2254
Mailing Address - Country:US
Mailing Address - Phone:201-919-0108
Mailing Address - Fax:
Practice Address - Street 1:116 WESTON AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2254
Practice Address - Country:US
Practice Address - Phone:201-919-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052172001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ074968Medicare ID - Type Unspecified