Provider Demographics
NPI:1689440786
Name:WENETZKY COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:WENETZKY COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENETZKY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:208-486-0637
Mailing Address - Street 1:6824 19TH ST W # 251
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5528
Mailing Address - Country:US
Mailing Address - Phone:208-486-0637
Mailing Address - Fax:208-508-8008
Practice Address - Street 1:6824 19TH ST W # 251
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-5528
Practice Address - Country:US
Practice Address - Phone:208-486-0637
Practice Address - Fax:208-508-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty