Provider Demographics
NPI:1881742583
Name:WENDT, MARIE WESTLEY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:WESTLEY
Last Name:WENDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2499
Mailing Address - Country:US
Mailing Address - Phone:847-462-0267
Mailing Address - Fax:
Practice Address - Street 1:26 S LA GRANGE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2488
Practice Address - Country:US
Practice Address - Phone:708-802-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical