Individual
MRS. EVELYN M. WENZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CAP
Contact information
Practice address
1850 LEE RD STE 215, 6700 S. FLORIDA AVE., SUITE 29 LAKELAND, FL, WINTER PARK, FL 32789-2106
(407) 375-1214
Mailing address
3525 COUNTRY LAKES DR, BELLE ISLE, FL 32812-3530
(407) 375-1214
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3086
FL
1041C0700X
Clinical Social Worker
Primary
SW5764
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z002Y
BLUE CROSS BLUE SHIELD-
—
Enumeration date
10/04/2006
Last updated
05/29/2014
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