Provider Demographics
NPI:1851860704
Name:WENDLAND, BILLIE JO (LCSW-C)
Entity Type:Individual
Prefix:
First Name:BILLIE JO
Middle Name:
Last Name:WENDLAND
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:BJ
Other - Middle Name:
Other - Last Name:WENDLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:407 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1854
Mailing Address - Country:US
Mailing Address - Phone:410-517-5416
Mailing Address - Fax:
Practice Address - Street 1:407 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1854
Practice Address - Country:US
Practice Address - Phone:410-517-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD159151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty