Provider Demographics
NPI:1053444158
Name:WENDT, BECKY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:
Last Name:WENDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-2634
Mailing Address - Country:US
Mailing Address - Phone:815-561-8714
Mailing Address - Fax:
Practice Address - Street 1:11004 E US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6023
Practice Address - Country:US
Practice Address - Phone:816-806-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0019821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical