Provider Demographics
NPI:1881725828
Name:WENDT BARNETT, JAMIE L (LPCC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:WENDT BARNETT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:WENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1914
Mailing Address - Country:US
Mailing Address - Phone:701-476-7200
Mailing Address - Fax:
Practice Address - Street 1:3401 45TH ST S STE A
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8970
Practice Address - Country:US
Practice Address - Phone:701-356-4384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1550101YA0400X
ND759-15-13101YP2500X
ND759-15-13-345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)