Provider Demographics
NPI:1891382842
Name:WASHINGTON, WENDY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:WASHINGTON
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 1:181 E. EVANS STREET STE E6A
Mailing Address - Street 2:BTC-046
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2511
Mailing Address - Country:US
Mailing Address - Phone:843-874-0152
Mailing Address - Fax:843-799-2151
Practice Address - Street 1:181 E EVANS ST STE E6A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2511
Practice Address - Country:US
Practice Address - Phone:843-874-0152
Practice Address - Fax:843-799-2151
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8242101Y00000X, 101YM0800X, 106H00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPG0761Medicaid