Provider Demographics
NPI:1841471000
Name:EAMES, WENDY LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LYNN
Last Name:EAMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 RIVER ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:BELLEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53508
Mailing Address - Country:US
Mailing Address - Phone:608-424-9100
Mailing Address - Fax:608-424-9099
Practice Address - Street 1:1075 N ELM ST
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-1205
Practice Address - Country:US
Practice Address - Phone:608-348-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3843-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43718500OtherMEDICAL ASSISTANCE