Provider Demographics
NPI:1568820371
Name:CARGNEL, WENDY (MA, LSC, LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CARGNEL
Suffix:
Gender:F
Credentials:MA, LSC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2437
Mailing Address - Country:US
Mailing Address - Phone:330-407-1933
Mailing Address - Fax:
Practice Address - Street 1:708 TREMONT AVE SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-6471
Practice Address - Country:US
Practice Address - Phone:330-407-1933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500292101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor