Provider Demographics
NPI:1134140387
Name:BARNES, WENDY L (LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:MCHE (CREDS)
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-1600
Mailing Address - Fax:210-916-4040
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE (CREDS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-1600
Practice Address - Fax:210-916-4040
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18864OtherTX LIC #
TX175077001Medicaid