Provider Demographics
NPI:1508044892
Name:GARRISON, WENDY SUZANN
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:SUZANN
Last Name:GARRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUZANN
Other - Last Name:POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LIMHP/LADC
Mailing Address - Street 1:285 S 68TH STREET PL
Mailing Address - Street 2:SUITE 319
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2572
Mailing Address - Country:US
Mailing Address - Phone:402-432-3746
Mailing Address - Fax:402-323-3399
Practice Address - Street 1:285 S 68TH STREET PL
Practice Address - Street 2:SUITE 319
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2572
Practice Address - Country:US
Practice Address - Phone:402-432-3746
Practice Address - Fax:402-323-3399
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE598101YA0400X
NE2749101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)