MEDICARE: BRITTNEY ILEANA VAN WEZEL MSW, LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.2607978	OH
2	104100000X	Social Worker	S.2107073	OH

General Provider Information

NPI Number	:	1699472118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY ILEANA VAN WEZEL MSW, LISW

Provider Business Mailing Address
First Line	:	522 BRAYSHAW DR
Second Line	:
City	:	OSTRANDER
State	:	OH
Zip	:	43061-3503
Country	:	US
Telephone Number	:	419-934-1283
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 BRAYSHAW DR
Second Line	:
City	:	OSTRANDER
State	:	OH
Zip	:	43061-3503
Country	:	US
Telephone Number	:	419-934-1283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	04/10/2026

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