Individual provider Active NPI

Linda Benezra Wachtel, LMSW

  • Community/Behavioral Health Agency
  • Tenafly, NJ
National Provider Identifier
1043647357
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
027610 Issued in NY
Practice address
121 Stonehurst Dr
Tenafly, NJ 07670-2946
Phone
(201) 816-0996
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 027610 NY Primary

Addresses

Primary practice location

121 Stonehurst Dr
Tenafly, NJ 07670-2946

Mailing address

121 Stonehurst Dr
Tenafly, NJ 07670-2946
Phone (201) 816-0996

Other names 1

  • Mrs. Linda Benezra Wachtel Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
027610NYMDCommunity/Behavioral Health Agency

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1043647357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 STONEHURST DR",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702946",
            "telephone_number": "201-816-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 STONEHURST DR",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702946",
            "telephone_number": "201-816-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHTEL",
        "first_name": "LINDA",
        "middle_name": "BENEZRA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "027610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "WACHTEL",
            "middle_name": "BENEZRA",
            "prefix": "MRS.",
            "credential": "LMSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tenafly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.