Nicole R Wendt, LPC-IT | |
414 Doctors Ct, Oshkosh, WI 54901-2065 | |
(920) 303-5100 | |
Not Available |
Full Name | Nicole R Wendt |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 414 Doctors Ct, Oshkosh, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578013702 | NPI | - | NPPES |
100061418 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3196-226 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
---|---|
Nicole R Wendt, LPC-IT Po Box 735044, Chicago, IL 60673-5044 Ph: (920) 303-5100 | Nicole R Wendt, LPC-IT 414 Doctors Ct, Oshkosh, WI 54901-2065 Ph: (920) 303-5100 |
Sandra Magnuson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 220 Washington Ave, Oshkosh, WI 54901 Phone: 920-236-4600 | |
Dr. Janet W Hagen, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Candlelight Ct, Oshkosh, WI 54904 Phone: 920-420-3825 | |
Krista Kay Moore, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 S Washburn St, Oshkosh, WI 54904 Phone: 920-232-2332 | |
Heidi Balke, Counselor Medicare: Not Enrolled in Medicare Practice Location: 515 S Washburn St Ste 104, Oshkosh, WI 54904 Phone: 920-236-8570 | |
Patrick M Carlson, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 S Washburn St, Oshkosh, WI 54904 Phone: 920-232-2332 | |
Ms. Angeline Fischer Gonzales, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 S Washburn St, Oshkosh, WI 54904 Phone: 920-232-2332 | |
Thomas Mittelsteadt, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 S Oakwood Rd Ste 102, Oshkosh, WI 54904 Phone: 920-223-8570 Fax: 920-223-8591 |