Provider Demographics
NPI:1710676820
Name:FRITZ, WENDY ANNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ANNE
Last Name:FRITZ
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 1:5525 PRINCE PHILLIP WAY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3323
Mailing Address - Country:US
Mailing Address - Phone:678-995-9409
Mailing Address - Fax:
Practice Address - Street 1:610 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:GA
Practice Address - Zip Code:30079-1124
Practice Address - Country:US
Practice Address - Phone:404-507-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014283101YM0800X
GAAPC007869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health