Provider Demographics
NPI:1316321599
Name:PANSA, WAYNE KEVIN JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:KEVIN
Last Name:PANSA
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5205 W WOODMILL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4068
Mailing Address - Country:US
Mailing Address - Phone:302-455-7065
Mailing Address - Fax:866-888-0714
Practice Address - Street 1:5205 W WOODMILL DR STE 33
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:302-455-7065
Practice Address - Fax:866-888-0714
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00013201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical