Provider Demographics
NPI:1669402681
Name:CARROLL, WENDY S (LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:S
Last Name:CARROLL
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 873
Mailing Address - Street 2:PIEDMONT COUNSELING, LLC
Mailing Address - City:MADISON
Mailing Address - State:VA
Mailing Address - Zip Code:22727
Mailing Address - Country:US
Mailing Address - Phone:540-948-4500
Mailing Address - Fax:
Practice Address - Street 1:40 COMMERCE LANE
Practice Address - Street 2:PIEDMONT COUNSELING, LLC , SUITE C
Practice Address - City:ROCHELLE
Practice Address - State:VA
Practice Address - Zip Code:22738
Practice Address - Country:US
Practice Address - Phone:540-948-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001312101YP2500X
VA0717000177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA145957OtherANTHEM BCBS
VA031195OtherVALUE OPTIONS