Provider Demographics
NPI:1558657122
Name:WENZL, SARAH R (MS, LMHP, CPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:WENZL
Suffix:
Gender:F
Credentials:MS, LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 REGENCY PARKWAY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3779
Mailing Address - Country:US
Mailing Address - Phone:402-932-2296
Mailing Address - Fax:402-281-0665
Practice Address - Street 1:444 REGENCY PARKWAY DR STE 104
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3779
Practice Address - Country:US
Practice Address - Phone:402-932-2296
Practice Address - Fax:402-281-0665
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health