Provider Demographics
NPI:1447426218
Name:PUGLISI, WENDY MARIE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:MARIE
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20221 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:ROHRERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21779-1116
Mailing Address - Country:US
Mailing Address - Phone:301-491-0705
Mailing Address - Fax:
Practice Address - Street 1:20221 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:ROHRERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21779-1116
Practice Address - Country:US
Practice Address - Phone:301-491-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0136101YA0400X
MD197491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)