Provider Demographics
NPI:1558757542
Name:CONTRERAS, WENDY ISAURA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ISAURA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:WENNDY
Other - Middle Name:ISAURA
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:39 1/2 STREET.
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 WILD ROSE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4705
Practice Address - Country:US
Practice Address - Phone:512-350-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health