Provider Demographics
NPI:1164549234
Name:GERSING, WENDY SUE (PSY, D)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:SUE
Last Name:GERSING
Suffix:
Gender:F
Credentials:PSY, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W. MAPLE STREET
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301
Mailing Address - Country:US
Mailing Address - Phone:307-324-4826
Mailing Address - Fax:307-324-0025
Practice Address - Street 1:214 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5530
Practice Address - Country:US
Practice Address - Phone:307-324-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY318101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY120836200OtherFEDERAL OWCP
WY119967600Medicaid
WY310397OtherBLUE CROSS BLUE SHIELD
WY119967600Medicaid