Provider Demographics
NPI:1821219932
Name:CLEMENS, WENDIE L (LPC)
Entity Type:Individual
Prefix:
First Name:WENDIE
Middle Name:L
Last Name:CLEMENS
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 1:104 NE AVONDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-1801
Mailing Address - Country:US
Mailing Address - Phone:918-231-5116
Mailing Address - Fax:
Practice Address - Street 1:104 NE AVONDALE AVE
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-1801
Practice Address - Country:US
Practice Address - Phone:918-231-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional