Provider Demographics
NPI:1649307950
Name:WEHN, LINDSEY AMBER (MA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:AMBER
Last Name:WEHN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 ELBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95425-4469
Mailing Address - Country:US
Mailing Address - Phone:707-287-1240
Mailing Address - Fax:
Practice Address - Street 1:776 S STATE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5847
Practice Address - Country:US
Practice Address - Phone:707-463-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51782106H00000X
CA51782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health