Provider Demographics
NPI:1992972764
Name:WENDT, BRUCE EDWARD (LPC, LCSW)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:EDWARD
Last Name:WENDT
Suffix:
Gender:M
Credentials:LPC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WESTHILL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3795
Mailing Address - Country:US
Mailing Address - Phone:715-847-2772
Mailing Address - Fax:715-847-2928
Practice Address - Street 1:3000 WESTHILL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3795
Practice Address - Country:US
Practice Address - Phone:715-847-2772
Practice Address - Fax:715-847-2928
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI442-125101YP2500X
WI1265-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical