Provider Demographics
NPI:1275970550
Name:WILSON, WENDY ELIZABETH (LPCC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ELIZABETH
Last Name:WILSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1264
Mailing Address - Country:US
Mailing Address - Phone:270-285-2409
Mailing Address - Fax:
Practice Address - Street 1:111 S MORGAN ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1552
Practice Address - Country:US
Practice Address - Phone:270-285-9023
Practice Address - Fax:270-285-9037
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1334101YP2500X
KY104257101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional