Provider Demographics
NPI:1932779428
Name:WENDLING, ERIN GIBBONS (PLPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:GIBBONS
Last Name:WENDLING
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 LAFAYETTE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-2508
Mailing Address - Country:US
Mailing Address - Phone:314-277-8577
Mailing Address - Fax:
Practice Address - Street 1:321 GREENBRIAR ESTATES DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3350
Practice Address - Country:US
Practice Address - Phone:314-277-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019037094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE