Provider Demographics
NPI:1033113667
Name:WENZEL, JOAN (LPC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:WENZEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 CLAYTONS WAY
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:IL
Mailing Address - Zip Code:61548-8567
Mailing Address - Country:US
Mailing Address - Phone:309-822-8172
Mailing Address - Fax:
Practice Address - Street 1:3249 BARNEY AVE
Practice Address - Street 2:
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-6234
Practice Address - Country:US
Practice Address - Phone:309-347-5522
Practice Address - Fax:309-347-7302
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health