Provider Demographics
NPI:1235581380
Name:ROBYN WENDELL, LCSW
Entity Type:Organization
Organization Name:ROBYN WENDELL, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-910-5279
Mailing Address - Street 1:4425 S MO PAC EXPY
Mailing Address - Street 2:SUITE 502
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6723
Mailing Address - Country:US
Mailing Address - Phone:512-910-5279
Mailing Address - Fax:
Practice Address - Street 1:4425 S MO PAC EXPY
Practice Address - Street 2:SUITE 502
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6723
Practice Address - Country:US
Practice Address - Phone:512-910-5279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX411371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty