Provider Demographics
NPI:1932092707
Name:WENDT, LIJA LITA (LLMSW)
Entity type:Individual
Prefix:
First Name:LIJA
Middle Name:LITA
Last Name:WENDT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 JEFFERSON AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4552
Mailing Address - Country:US
Mailing Address - Phone:989-948-1367
Mailing Address - Fax:
Practice Address - Street 1:4604 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2387
Practice Address - Country:US
Practice Address - Phone:989-948-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511201431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical