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NPI Code Detail

MEDICARE: SHERRY LYNE WENZEL LCSW

MEDICARE: SHERRY LYNE WENZEL LCSW
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
11041C0700XClinical Social WorkerSW10664FL
21041S0200XSchool Social WorkerSW 10664FL

Other Identifiers

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

General Provider Information

NPI Number : 1417213950
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRY LYNE WENZEL LCSW
Provider Business Mailing Address
First Line : 1940 MARAVILLA AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7135
Country : US
Telephone Number : 239-277-0096
Fax Number : 239-277-0662
Provider Business Practice Location Address
First Line : 1940 MARAVILLA AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-7135
Country : US
Telephone Number : 239-277-0096
Fax Number : 239-277-0662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2012
Last Update Date : 04/10/2012

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