Provider Demographics
NPI:1952623290
Name:DEAL, WENDY H (LPC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:H
Last Name:DEAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:HOLDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30156-0959
Mailing Address - Country:US
Mailing Address - Phone:678-637-4320
Mailing Address - Fax:
Practice Address - Street 1:3855 SHALLOWFORD RD
Practice Address - Street 2:SUITE 420
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4195
Practice Address - Country:US
Practice Address - Phone:770-592-0566
Practice Address - Fax:770-993-8004
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003915101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional