=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356053482
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY RODRIGUEZ SANCHEZ LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2022
-----------------------------------------------------
Last Update Date | 09/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 N FLORIDA MANGO RD
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33409-6416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-472-9990
-----------------------------------------------------
Fax | 561-848-4461
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2748 SW 120TH TER UNIT 1008
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33025-0763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-857-2408
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW20871
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------