Active NPI
Wendy J Petzel, LMFT
- Marriage & Family Therapist
- Tolland, CT
National Provider Identifier
1083649503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 000880
- Practice address
- 384 Merrow Rd Ste Y
Tolland, CT 06084-3957 - Phone
- (860) 796-1007
- Fax
- (860) 875-7214
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 000880 | CT | Primary |
Addresses
Primary practice location
384 Merrow Rd Ste Y
Tolland, CT 06084-3957
Mailing address
384 Merrow Rd Ste Y
Tolland, CT 06084-3957
Phone (860) 796-1007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000880 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083649503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "384 MERROW RD STE Y",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060843957",
"telephone_number": "860-796-1007",
"fax_number": "860-875-7214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "384 MERROW RD STE Y",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060843957",
"telephone_number": "860-796-1007",
"fax_number": "860-875-7214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETZEL",
"first_name": "WENDY",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "000880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolland, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.