Individual provider Active NPI

Stephanie Wendland

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1114371218
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.011235 Issued in IL
Practice address
29 S Webster St Ste 250
Naperville, IL 60540-4560
Phone
(630) 420-2596
Fax
(630) 420-2796
NPI assigned
Apr 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401223765 MI
Professional Counselor 101YP2500X 180.011235 IL Primary

Addresses

Primary practice location

29 S Webster St Ste 250
Naperville, IL 60540-4560

Mailing address

4454 E Timberwood Dr
Traverse City, MI 49686-3838
Phone (630) 362-4359

Other practice location 1

810 Cottageview Dr Ste 102
Traverse City, MI 49684-2392
Phone (630) 362-4359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 9, 2025 through Jun 9, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401223765MIMDCounselor
180.011235ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie Wendland LPC PLLC Professional CurrentSince Oct 29, 2023 Accepting new patients

Locations

810 Cottageview Dr
Ste 102
Traverse City, MI 49684
Phone (231) 714-4840

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1114371218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 E TIMBERWOOD DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863838",
            "telephone_number": "630-362-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST STE 250",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404560",
            "telephone_number": "630-420-2596",
            "fax_number": "630-420-2796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 Cottageview Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842392",
            "country_code": "US",
            "telephone_number": "630-362-4359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENDLAND",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401223765",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.