Provider Demographics
NPI:1609163021
Name:CARTER, WENDY JEAN (CSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:JEAN
Last Name:CARTER
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N INSTITUTE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2853
Mailing Address - Country:US
Mailing Address - Phone:719-331-3721
Mailing Address - Fax:
Practice Address - Street 1:1519 E BOULDER ST # D1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5663
Practice Address - Country:US
Practice Address - Phone:719-331-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099231901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13577870OtherCAQH
COCSW.09923190OtherPROFESSIONAL LICENSE