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General NPI Number Information
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NPI Number | 1871632869
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Entity Type | Individual
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Provider Name | WENDY ANN TREFZ LCSW, CSAC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/11/2021
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Provider Practice Location Address
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Address Line | 6501 3RD AVE STE 4
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City | KENOSHA
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State | WI
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Zip | 53143-5111
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Country | US
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Telephone | 262-914-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 7524 LILY LAKE RD
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City | BURLINGTON
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State | WI
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Zip | 53105-8807
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Country | US
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Telephone | 262-914-3101
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1968
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License Number State | WI
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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 | 7847-123
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License Number State | WI
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