Provider Demographics
NPI:1912102757
Name:SCHILL, WENDY MARIE (LCSW 20861)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:SCHILL
Suffix:
Gender:F
Credentials:LCSW 20861
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79090 ASHLEY PL
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4296
Mailing Address - Country:US
Mailing Address - Phone:760-898-3512
Mailing Address - Fax:
Practice Address - Street 1:77564 COUNTRY CLUB DR STE 410
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6252
Practice Address - Country:US
Practice Address - Phone:760-898-3512
Practice Address - Fax:760-890-6040
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 20861104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MMM00427MMedicare ID - Type Unspecified