Provider Demographics
NPI:1073601803
Name:GRIFFIN-ALLEN, WENDY (LMFT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GRIFFIN-ALLEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-4750
Mailing Address - Country:US
Mailing Address - Phone:260-484-4153
Mailing Address - Fax:260-484-2337
Practice Address - Street 1:818 W PARK DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-2620
Practice Address - Country:US
Practice Address - Phone:812-319-1849
Practice Address - Fax:260-484-2337
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
IN35001490A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)