Provider Demographics
NPI:1275611519
Name:LAIRD, WENDA LEE (LPC)
Entity Type:Individual
Prefix:
First Name:WENDA
Middle Name:LEE
Last Name:LAIRD
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 1:1831 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4853
Mailing Address - Country:US
Mailing Address - Phone:307-259-4922
Mailing Address - Fax:
Practice Address - Street 1:2521 E 15TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4126
Practice Address - Country:US
Practice Address - Phone:307-237-7444
Practice Address - Fax:307-473-7144
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health