Provider Demographics
NPI:1073008082
Name:WENDY NADOLNY, LCSW, LLC
Entity Type:Organization
Organization Name:WENDY NADOLNY, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NADOLNY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-846-0492
Mailing Address - Street 1:11 W VICTORY WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2605
Mailing Address - Country:US
Mailing Address - Phone:970-846-0492
Mailing Address - Fax:970-824-5555
Practice Address - Street 1:11 W VICTORY WAY STE 203
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2605
Practice Address - Country:US
Practice Address - Phone:970-846-0492
Practice Address - Fax:970-824-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000000061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty