Provider Demographics
NPI:1932785649
Name:LUCE, WENDY L (LCSW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:LUCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10674 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:GOWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14070-1384
Mailing Address - Country:US
Mailing Address - Phone:716-532-3325
Mailing Address - Fax:716-995-2127
Practice Address - Street 1:10674 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GOWANDA
Practice Address - State:NY
Practice Address - Zip Code:14070-1384
Practice Address - Country:US
Practice Address - Phone:716-532-3325
Practice Address - Fax:716-995-2127
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072993-011041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool