Healthcare Provider Details

I. General information

NPI: 1285682708
Provider Name (Legal Business Name): WENDY KAY DREWS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11590 SEMINOLE BLVD A-3 NORTHSTAR COUNSELING
LARGO FL
33778-3204
US

IV. Provider business mailing address

3531 18TH ST N
ST PETERSBURG FL
33713-2811
US

V. Phone/Fax

Practice location:
  • Phone: 727-391-7101
  • Fax: 727-521-4638
Mailing address:
  • Phone: 727-391-7101
  • Fax: 727-521-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 5975
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801080915
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: