Wendy J Blackwood, MS, LAC, NCC
Individual provider Active NPI Professional Counselor · Conway, AR
NPI 1124239538 · NPPES record last updated Mar 19, 2015
Key facts
- NPI
- 1124239538
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- P0801005 (AR)
- Practice address
- 1422 Caldwell St
Conway, AR 72034-5319 - Phone
- (501) 327-7224
- Fax
- (501) 327-7224
- NPI assigned
- May 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0801005 | AR | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P0801005 | AR | Yes |
| Specialist | 174400000X | P0801005 | AR |
Addresses
Primary practice location
1422 Caldwell St
Conway, AR 72034-5319
Mailing address
1422 Caldwell St
Conway, AR 72034-5319
Phone (501) 327-7224
Other providers in Conway, AR
- Nickolas Black
- Taylor Michelle Black
- Kalone Blackmon
- Zachary Blackmon
- Arlinda Blackwell-El
- Cameria Blake
- Kimberly Lorene Blake
- Aimee M Blalock
- Blankenship Management Co.
- Heather Yvonne Blankenship
All providers in Conway, AR · Professional Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.