Individual provider Active NPI

Lawrence Joseph Wenz, PSY.D.

  • Psychologist
  • Monroe, NY
National Provider Identifier
1285612127
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8688 Issued in NY
Practice address
151 Conklin Rd
Monroe, NY 10950-3644
Phone
(845) 782-0872
Fax
(845) 782-2586
NPI assigned
Dec 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8688 NY Primary

Addresses

Primary practice location

151 Conklin Rd
Monroe, NY 10950-3644

Mailing address

151 Conklin Rd
Monroe, NY 10950-3644
Phone (845) 782-0872

Other identifiers 1

IdentifierTypeStateIssuer
01969951MedicaidNY

Other names 1

  • Lawrence J. Wenz, Psy.D., P.C. Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160630000650 NY Practitioner - Clinical Psychologist 8628360229 Practice locations: Monroe, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

151 Conklin Rd
Monroe, NY 10950-3644
Phone (845) 782-0872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8688NYMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1285612127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CONKLIN RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503644",
            "telephone_number": "845-782-0872",
            "fax_number": "845-782-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CONKLIN RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503644",
            "telephone_number": "845-782-0872",
            "fax_number": "845-782-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZ",
        "first_name": "LAWRENCE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-31",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "8688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01969951",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAWRENCE",
            "last_name": "WENZ, PSY.D., P.C.",
            "middle_name": "J.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.