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General NPI Number Information
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NPI Number | 1619486776
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Entity Type | Individual
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Provider Name | ADAM LEE WESNER LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 21425 SPRING ST
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City | UNION GROVE
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State | WI
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Zip | 53182
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Country | US
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Telephone | 262-878-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 21425 SPRING ST
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City | UNION GROVE
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State | WI
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Zip | 53182-9707
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Country | US
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Telephone | 262-878-7000
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Fax |
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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 | 8720
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License Number State | WI
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