Provider Demographics
NPI:1427303775
Name:HARDEN, WENDELL I (BA, CASAC)
Entity type:Individual
Prefix:MR
First Name:WENDELL
Middle Name:I
Last Name:HARDEN
Suffix:
Gender:M
Credentials:BA, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6305
Mailing Address - Country:US
Mailing Address - Phone:718-583-5315
Mailing Address - Fax:718-583-3561
Practice Address - Street 1:1910 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6305
Practice Address - Country:US
Practice Address - Phone:718-583-5315
Practice Address - Fax:718-583-3561
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19806101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)