Provider Demographics
NPI:1003239252
Name:CREATIVE SOLUTIONS, PAMELA WENDT COUNSELING INC.
Entity Type:Organization
Organization Name:CREATIVE SOLUTIONS, PAMELA WENDT COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:WENDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-202-9506
Mailing Address - Street 1:116 N CHESTNUT ST
Mailing Address - Street 2:STE 220
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-4037
Mailing Address - Country:US
Mailing Address - Phone:217-202-9506
Mailing Address - Fax:
Practice Address - Street 1:116 N CHESTNUT ST
Practice Address - Street 2:STE 220
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-4037
Practice Address - Country:US
Practice Address - Phone:217-202-9506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006584251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health