Provider Demographics
NPI:1356406870
Name:WEGMANN, MARY HELEN 'NELL' (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:MARY HELEN
Middle Name:'NELL'
Last Name:WEGMANN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:NELL
Other - Middle Name:HELEN
Other - Last Name:WEGMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:505 LIBBIE AVE
Mailing Address - Street 2:COUPLES COUNSELING LLC
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2617
Mailing Address - Country:US
Mailing Address - Phone:804-873-0338
Mailing Address - Fax:
Practice Address - Street 1:505 LIBBIE AVE
Practice Address - Street 2:COUPLES COUNSELING LLC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2617
Practice Address - Country:US
Practice Address - Phone:804-873-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI79-124106H00000X
VA0717001201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI79-124OtherLMFT
VA0717001201OtherVIRGINIA LMFT