Provider Demographics
NPI:1295995348
Name:PANNELL, WENDE GAY (LCPC, CADC, LPC)
Entity type:Individual
Prefix:MS
First Name:WENDE
Middle Name:GAY
Last Name:PANNELL
Suffix:
Gender:F
Credentials:LCPC, CADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 N MAY ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-2949
Mailing Address - Country:US
Mailing Address - Phone:630-417-7555
Mailing Address - Fax:630-896-1689
Practice Address - Street 1:733 N MAY ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2949
Practice Address - Country:US
Practice Address - Phone:630-417-7555
Practice Address - Fax:630-896-1689
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.0006927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health