Provider Demographics
NPI:1568775948
Name:WANDLER, JAMES (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:WANDLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-9329
Mailing Address - Country:US
Mailing Address - Phone:208-265-6798
Mailing Address - Fax:
Practice Address - Street 1:1717 ONTARIO ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-9329
Practice Address - Country:US
Practice Address - Phone:208-265-6798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional