Provider Demographics
NPI:1780893180
Name:PEGAN, WENDY BOTTOMS (LMHC)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:BOTTOMS
Last Name:PEGAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1180
Mailing Address - Country:US
Mailing Address - Phone:716-446-9226
Mailing Address - Fax:716-741-9139
Practice Address - Street 1:7345 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1180
Practice Address - Country:US
Practice Address - Phone:716-446-9226
Practice Address - Fax:716-741-9139
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health