Individual ProviderBrendaliz FadulCounselorBehavioral Health & Social Service ProvidersPractice Address19 W 21st St, Suite1003, New York, NY 10010(917) 909-6806(845) 591-8439PECOS EnrollmentBased on the most recent information from CMS, provider Brendaliz Fadul does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:42 AM.Profile DetailsProvider ID1508528530Provider TypeIndividualFull NameFadul, BrendalizCredentialMHCGenderFemaleSole ProprietorYesEnumeration Date10/7/2021Last Updated7/26/2023Contact InformationPractice LocationPractice Address19 W 21st St, Suite1003, New York, NY 10010Phone(917) 909-6806FaxUnlisted FaxMailing LocationMailing Address41 Oxford Ln, Harriman, NY 10926-3008Phone(845) 591-8439FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense013257-01New York