Basic Information
Provider Information
NPI: 1831713239
EntityType: 2
ReplacementNPI:  
OrganizationName: WENDY CASE LLC
LastName:  
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Mailing Information
Address1: 32406 FRANKLIN RD UNIT 250612
Address2:  
City: FRANKLIN
State: MI
PostalCode: 480257023
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 32841 MIDDLEBELT RD STE 407
Address2:  
City: FARMINGTON HILLS
State: MI
PostalCode: 483341771
CountryCode: US
TelephoneNumber: 2482178511
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/01/2020
LastUpdateDate: 06/01/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: CASE
AuthorizedOfficialFirstName: WENDY
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AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2482178511
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: LPC
NPICertificationDate: 06/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X  Y193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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