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NPI 1053747311

NPI 1053747311 : WENDY G FLEAGANE MSW, LISW : CAMBRIDGE, OH

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General NPI Number Information
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    NPI Number           |    1053747311
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    Entity Type          |    Individual 
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    Provider Name        |    WENDY G FLEAGANE MSW, LISW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2013
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    Last Update Date     |    12/21/2021
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Provider Practice Location Address
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    Address Line         |    2500 GLENN HWY 
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    City                 |    CAMBRIDGE
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    State                |    OH
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    Zip                  |    43725-9028
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    Country              |    US
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    Telephone            |    740-439-4428
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    Fax                  |    740-439-3389
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Provider Business Mailing Address
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    Address Line         |    2845 BELL ST 
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    City                 |    ZANESVILLE
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    State                |    OH
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    Zip                  |    43701-1720
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    Country              |    US
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    Telephone            |    740-454-9766
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    Fax                  |    740-588-6452
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    ACC.0006294
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    License Number State |    CO
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    I.1700706
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    License Number State |    OH
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