Provider Demographics
NPI:1912044587
Name:URBAN, WENDY (LCPC, LCMFT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:LCPC, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 IVYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5490
Mailing Address - Country:US
Mailing Address - Phone:301-388-0387
Mailing Address - Fax:301-388-0387
Practice Address - Street 1:1572 IVYSTONE CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5490
Practice Address - Country:US
Practice Address - Phone:301-388-0387
Practice Address - Fax:301-388-0387
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0035101YP2500X
MDLCM082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist