Healthcare Provider Details

I. General information

NPI: 1689610040
Provider Name (Legal Business Name): AUDREY ANN WENDT MSW, LMSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1382 E HULL RD
HOPE MI
48628-9767
US

IV. Provider business mailing address

1382 E HULL RD
HOPE MI
48628-9767
US

V. Phone/Fax

Practice location:
  • Phone: 989-388-4185
  • Fax: 989-388-4187
Mailing address:
  • Phone: 989-689-4052
  • Fax: 989-689-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2-00817
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801092278
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: