Individual provider Active NPI

Mary Anne Millare Wenceslao, LCSW, LCDC

  • Clinical Social Worker
  • Lewisville, TX
National Provider Identifier
1427236876
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
51086 Issued in TX
Practice address
926 Witherby LN
Lewisville, TX 75067-4477
Phone
(888) 317-7021
NPI assigned
Feb 7, 2008
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10883 TX
Clinical Social Worker 1041C0700X 51086 TX Primary

Addresses

Primary practice location

926 Witherby LN
Lewisville, TX 75067-4477

Mailing address

926 Witherby LN
Lewisville, TX 75067-4477
Phone (888) 317-7021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20251029000220 TX Practitioner - Clinical Social Worker 7416446638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1705 Yeddo Path
Flower Mound, TX 75028-4331

2023 W Ranch Rd
Farmington, UT 84025-5029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10883TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Online Counseling PLLC CurrentSince Oct 17, 2025 Accepting new patients
Collaborative Counseling PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1427236876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 WITHERBY LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674477",
            "telephone_number": "888-317-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 WITHERBY LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674477",
            "telephone_number": "888-317-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENCESLAO",
        "first_name": "MARY ANNE",
        "middle_name": "MILLARE",
        "credential": "LCSW, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "10883",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.