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General NPI Number Information
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NPI Number | 1366749053
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Entity Type | Individual
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Provider Name | NADEJA DOLORES WESLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 10331 CHAMPION FARMS DR
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City | LOUISVILLE
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State | KY
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Zip | 40241-6129
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Country | US
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Telephone | 708-917-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 10331 CHAMPION FARMS DR
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City | LOUISVILLE
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State | KY
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Zip | 40241-6129
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Country | US
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Telephone | 708-917-5129
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Fax | 812-206-1213
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34007047A
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License Number State | IN
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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 | 149.012567
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 253243
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License Number State | KY
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