Mary Kathleen Wentzel, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC.0017459 Issued in CO

Practice address

812 Grand Ave Ste 210
Glenwood Springs, CO 81601-3478

Phone

(970) 379-1588

NPI assigned

Apr 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Mac Therapy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1326620170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SOPRIS AVE APT SUITE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014440",
            "telephone_number": "970-379-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 GRAND AVE STE 210",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816013478",
            "telephone_number": "970-379-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZEL",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPCC.0017459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "THERAPY",
            "middle_name": "MAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leslie L Way, LPC
• Jacqueline Weast, LCSW
• Sierra Rose Weast, BSW
• Drew Wegert, CST, CSFA
• Gordon David Weidemann, MSPT
• Thomas Wessel, DC
• Western Slope Oncology Associates PC
• Robyn L Whaley, RN
• Raquel M. Whitehead, R.N.
• April Whitham

• Professional Counselor in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.