Provider Demographics
NPI:1740440718
Name:OPPENHEIM, WENDY L (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:L
Last Name:OPPENHEIM
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 1:45 COUNTRY WALK
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2554
Mailing Address - Country:US
Mailing Address - Phone:856-424-7547
Mailing Address - Fax:856-414-1918
Practice Address - Street 1:800 N KINGS HWY
Practice Address - Street 2:SUITE 504
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1511
Practice Address - Country:US
Practice Address - Phone:856-414-0049
Practice Address - Fax:856-414-1918
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001856001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ460448000OtherMAGELLAN HEALTH SERVICES