Provider Demographics
NPI:1609895259
Name:WHEELER, LENA LOU (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LENA
Middle Name:LOU
Last Name:WHEELER
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:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78364-1236
Mailing Address - Country:US
Mailing Address - Phone:361-516-1080
Mailing Address - Fax:361-516-1076
Practice Address - Street 1:1429 S 6TH ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-6253
Practice Address - Country:US
Practice Address - Phone:361-516-1080
Practice Address - Fax:361-516-1076
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical