Provider Demographics
NPI:1407973639
Name:BIELLO, WENDY (LSW)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:BIELLO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 CLIFTON PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3412
Mailing Address - Country:US
Mailing Address - Phone:216-228-5659
Mailing Address - Fax:
Practice Address - Street 1:6209 STORER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102
Practice Address - Country:US
Practice Address - Phone:216-651-1450
Practice Address - Fax:216-651-4351
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0025151104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker