Healthcare Provider Details

I. General information

NPI: 1982798708
Provider Name (Legal Business Name): KAROL JEAN WENDT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ELM GROVE RD STE 325
ELM GROVE WI
53122-2561
US

IV. Provider business mailing address

500 ELM GROVE RD STE 325
ELM GROVE WI
53122-2561
US

V. Phone/Fax

Practice location:
  • Phone: 262-641-4347
  • Fax: 262-641-4350
Mailing address:
  • Phone: 262-641-4347
  • Fax: 262-641-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2419
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number221
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: