Provider Demographics
NPI:1881857431
Name:NEWCOMB-BEATTIE, WENDY LEE (LCMHC/LPC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LEE
Last Name:NEWCOMB-BEATTIE
Suffix:
Gender:F
Credentials:LCMHC/LPC
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:LEE
Other - Last Name:NEWCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC/LPC
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-0096
Mailing Address - Country:US
Mailing Address - Phone:732-330-1720
Mailing Address - Fax:
Practice Address - Street 1:263 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8701
Practice Address - Country:US
Practice Address - Phone:732-330-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7031101YP2500X
NJ37PC00470100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103962Medicaid
NC19P3KOtherBCBS OF NC
NC1881857431Medicaid