Healthcare Provider Details

I. General information

NPI: 1497523252
Provider Name (Legal Business Name): WENDY SANDS WILSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY SANDS

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N UNIVERSITY AVE STE 915
LITTLE ROCK AR
72207-5238
US

IV. Provider business mailing address

1501 N UNIVERSITY AVE STE 915
LITTLE ROCK AR
72207-5238
US

V. Phone/Fax

Practice location:
  • Phone: 501-492-6860
  • Fax: 501-406-3671
Mailing address:
  • Phone: 501-492-6860
  • Fax: 501-406-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12826-C
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: