Provider Demographics
NPI:1013802917
Name:DEMEKE, WANDA FAYE (LMHC)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:FAYE
Last Name:DEMEKE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:FAYE
Other - Last Name:HAYWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 E LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-3139
Mailing Address - Country:US
Mailing Address - Phone:260-426-3347
Mailing Address - Fax:260-424-2248
Practice Address - Street 1:333 E LEWIS ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3139
Practice Address - Country:US
Practice Address - Phone:260-426-3347
Practice Address - Fax:260-424-2248
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39005507A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health