Provider Demographics
NPI:1487218046
Name:WENDELL COUNSELING, LLC
Entity Type:Organization
Organization Name:WENDELL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-862-0892
Mailing Address - Street 1:600 WYNDHURST AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2432
Mailing Address - Country:US
Mailing Address - Phone:443-862-0892
Mailing Address - Fax:
Practice Address - Street 1:600 WYNDHURST AVE STE 112
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2432
Practice Address - Country:US
Practice Address - Phone:443-862-0892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health