NPIMap

Individual provider Active NPI

Bruce Edward Wendt, LPC, LCSW

  • Professional Counselor
  • Wausau, WI
National Provider Identifier
1992972764
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
442-125 Issued in WI
Practice address
3000 Westhill Dr
Suite 100
Wausau, WI 54401-3795
Phone
(715) 847-2772
Fax
(715) 847-2928
NPI assigned
May 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 442-125 WI Primary
Clinical Social Worker 1041C0700X 1265-123 WI

Addresses

Primary practice location

3000 Westhill Dr
Suite 100
Wausau, WI 54401-3795

Mailing address

3000 Westhill Dr
Suite 100
Wausau, WI 54401-3795
Phone (715) 847-2772

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

LicenseStateTypeSpecialty
442-125WIMDProfessional Counselor
1265-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1992972764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DR",
            "address_2": "SUITE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013795",
            "telephone_number": "715-847-2772",
            "fax_number": "715-847-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DR",
            "address_2": "SUITE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013795",
            "telephone_number": "715-847-2772",
            "fax_number": "715-847-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LPC, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "442-125",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1265-123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.