Provider Demographics
NPI:1396966834
Name:ENT, WENDIE GAYLE (LMHC, CAP, NCGC-II)
Entity type:Individual
Prefix:
First Name:WENDIE
Middle Name:GAYLE
Last Name:ENT
Suffix:
Gender:F
Credentials:LMHC, CAP, NCGC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 SPARROW AVE
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1917
Mailing Address - Country:US
Mailing Address - Phone:727-492-8037
Mailing Address - Fax:
Practice Address - Street 1:1730 S PINELLAS AVE
Practice Address - Street 2:SUITE G
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-1959
Practice Address - Country:US
Practice Address - Phone:727-492-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health