Provider Demographics
NPI:1659003515
Name:SHENK-WENGER, ELIZABETH ANN (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SHENK-WENGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:SHENK
Other - Last Name:WENGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1824 WILLOW STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4832
Mailing Address - Country:US
Mailing Address - Phone:717-575-2737
Mailing Address - Fax:
Practice Address - Street 1:2501 OREGON PIKE STE 105
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4890
Practice Address - Country:US
Practice Address - Phone:717-735-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health