Provider Demographics
NPI:1831294123
Name:TOMPKINS, WENDY KAY (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:KAY
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:KAY
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:1170 COLORADO AVENUE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501
Mailing Address - Country:US
Mailing Address - Phone:970-241-2948
Mailing Address - Fax:970-242-4219
Practice Address - Street 1:1170 COLORADO AVENUE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501
Practice Address - Country:US
Practice Address - Phone:970-241-2948
Practice Address - Fax:970-242-4219
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9917911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC69106Medicare ID - Type Unspecified