Healthcare Provider Details

I. General information

NPI: 1972773497
Provider Name (Legal Business Name): WENDY JO VATTER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 PLEASANT ST
BERLIN NH
03570-2006
US

IV. Provider business mailing address

323 N STATE ST
CARO MI
48723-1537
US

V. Phone/Fax

Practice location:
  • Phone: 603-752-2040
  • Fax:
Mailing address:
  • Phone: 989-673-6191
  • Fax: 989-672-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801087719
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberEL32259
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: