Active NPI
Cornelia Wenze, ED.D.
- Professional Counselor
- Fayetteville, GA
National Provider Identifier
1528108099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 010382
- Practice address
- 500 Lanier Ave W Ste 103B
Fayetteville, GA 30214-7640 - Phone
- (404) 800-4002
- Fax
- (404) 393-5698
- NPI assigned
- Feb 7, 2007
- Last updated
- May 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH7527 | FL | |
| Professional Counselor | 101YP2500X | 010382 | GA | Primary |
Addresses
Primary practice location
500 Lanier Ave W Ste 103B
Fayetteville, GA 30214-7640
Mailing address
2600 Main St Unit 120
Porterdale, GA 30070-3305
Phone (404) 618-4843
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 |
|---|---|---|---|
| MH7527 | FL | MD | Mental Health Counselor |
| 010382 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1528108099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 MAIN ST UNIT 120",
"city": "PORTERDALE",
"state": "GA",
"postal_code": "300703305",
"telephone_number": "404-618-4843",
"fax_number": "470-441-9183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 LANIER AVE W STE 103B",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147640",
"telephone_number": "404-800-4002",
"fax_number": "404-393-5698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZE",
"first_name": "CORNELIA",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH7527",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "010382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
- Well3Plus Collaborative Care, LLC
- Wellness Medical Solutions LLC
- Wellspring Life Educational & Counseling Group
- Wellstreet of Georgia PC
- Wellstreet of Georgia PC (Piedmont Urgent Care by Wellstreet)
- Spencer David Wenzel
- Janae Crashone Whatley-Flecha, MS, BCBA
- Tameika Denise Wheeler-Hall, D.M.D.
- Lara Book Whitaker, P.T.
- Julian Christopher White, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.