Provider Demographics
NPI:1619201506
Name:CHAPUT, WENDY L (LPC)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:L
Last Name:CHAPUT
Suffix:
Gender:F
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:PO BOX 13156
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54307-3156
Mailing Address - Country:US
Mailing Address - Phone:920-403-7600
Mailing Address - Fax:920-403-7360
Practice Address - Street 1:1511 W MAIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9556
Practice Address - Country:US
Practice Address - Phone:920-403-7600
Practice Address - Fax:920-403-7360
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2771 - 125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional