MEDICARE: WHITNEY LENTZ WELLNESS

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
1	101YM0800X	Mental Health Counselor	71425	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1790295665	OTHER	TX	NIP

General Provider Information

NPI Number	:	1790295665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITNEY LENTZ WELLNESS

Provider Business Mailing Address
First Line	:	3263 S IVY WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-7557
Country	:	US
Telephone Number	:	214-726-5235
Fax Number	:

Provider Business Practice Location Address
First Line	:	8751 E HAMPDEN AVE STE A3
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-4928
Country	:	US
Telephone Number	:	214-726-5235
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	WHITNEY LENTZ
Credential	:	LPC
Telephone Number	:	214-726-5235

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	01/20/2020

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