Provider Demographics
NPI:1245379379
Name:ANDERSON, WENDI KAY (MASTER OF SCIENCE MS)
Entity type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:KAY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE MS
Other - Prefix:MISS
Other - First Name:WENDI
Other - Middle Name:KAY
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTER OF SCIENCE MS
Mailing Address - Street 1:2444 O STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-475-7666
Mailing Address - Fax:402-476-9623
Practice Address - Street 1:2444 O STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-475-7666
Practice Address - Fax:402-476-9623
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2285101YM0800X
NE1272101YM0800X
NE1018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE134580OtherVALUE OPTIONS
NE84588OtherBCBS
NE250259OtherMIDLANDS CHOICE