Provider Demographics
NPI:1891782314
Name:PIPENTACOS, WENDY W (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:W
Last Name:PIPENTACOS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 E KACHINA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-4923
Mailing Address - Country:US
Mailing Address - Phone:520-228-2104
Mailing Address - Fax:520-228-5283
Practice Address - Street 1:5380 E KACHINA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707-4923
Practice Address - Country:US
Practice Address - Phone:520-228-2104
Practice Address - Fax:520-228-5283
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-13161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical