Provider Demographics
NPI:1801229091
Name:WENZEL, JOEL DOUGLAS (LGSW)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:DOUGLAS
Last Name:WENZEL
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2528
Mailing Address - Country:US
Mailing Address - Phone:612-296-2946
Mailing Address - Fax:
Practice Address - Street 1:6809 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2528
Practice Address - Country:US
Practice Address - Phone:612-296-2946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical