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NPI Code Detail

MEDICARE: ROBERT B. WENZEL M.A. LPC

MEDICARE: ROBERT B. WENZEL M.A. LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor3204CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
212018498OTHERCOCAQH

General Provider Information

NPI Number : 1003092727
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT B. WENZEL M.A. LPC
Provider Business Mailing Address
First Line : 4360 MONTEBELLO DR STE 400
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7224
Country : US
Telephone Number : 719-593-9228
Fax Number : 719-598-1705
Provider Business Practice Location Address
First Line : 4360 MONTEBELLO DR STE 400
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7224
Country : US
Telephone Number : 719-593-9228
Fax Number : 719-598-1705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2008
Last Update Date : 12/04/2009

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