Provider Demographics
NPI:1528297033
Name:WENZEL, MELANIE KAYE (MSW, LISW)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:KAYE
Last Name:WENZEL
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 NW 86TH ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131
Mailing Address - Country:US
Mailing Address - Phone:515-252-2522
Mailing Address - Fax:515-252-2523
Practice Address - Street 1:6165 NW 86TH ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131
Practice Address - Country:US
Practice Address - Phone:515-252-2522
Practice Address - Fax:515-252-2523
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical