Provider Demographics
NPI:1366781593
Name:HECKLER, WENDY KREISLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:KREISLE
Last Name:HECKLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 POWDER RIVER RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4129
Mailing Address - Country:US
Mailing Address - Phone:512-571-3735
Mailing Address - Fax:
Practice Address - Street 1:3006 BEE CAVE RD
Practice Address - Street 2:#A200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5588
Practice Address - Country:US
Practice Address - Phone:512-571-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical