Provider Demographics
NPI:1376216846
Name:KUNDE, WENDY JANELLE (LICSW)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JANELLE
Last Name:KUNDE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JANELLE
Other - Last Name:HARIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:1965 PROSPERITY RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3618
Mailing Address - Country:US
Mailing Address - Phone:952-913-2894
Mailing Address - Fax:
Practice Address - Street 1:5354 PARKDALE DR FL 2
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1603
Practice Address - Country:US
Practice Address - Phone:888-364-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN195821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical