Provider Demographics
NPI:1578952305
Name:PRICE, WENDY G (LPC)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:G
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:G
Other - Last Name:PRICE WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:
Mailing Address - City:CEDARTOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30125-1032
Mailing Address - Country:US
Mailing Address - Phone:678-861-6292
Mailing Address - Fax:706-528-4212
Practice Address - Street 1:701 E 2ND AVE SW STE A
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-6101
Practice Address - Country:US
Practice Address - Phone:678-861-6292
Practice Address - Fax:706-528-4212
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004670101YP2500X
GALPC009848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional