Provider Demographics
NPI:1013018506
Name:IGLEHART, WENDY SIMMONS (LCPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:SIMMONS
Last Name:IGLEHART
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:RAE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5525 TWIN KNOLLS RD
Mailing Address - Street 2:SUITE 327
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3266
Mailing Address - Country:US
Mailing Address - Phone:410-992-9149
Mailing Address - Fax:410-992-9921
Practice Address - Street 1:5525 TWIN KNOLLS RD
Practice Address - Street 2:SUITE 327
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3266
Practice Address - Country:US
Practice Address - Phone:410-992-9149
Practice Address - Fax:410-992-9921
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1673101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional