Mark Wendell, LPC, MA, MAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4798 Issued in LA

Practice address

13838 Boyter LN
Vivian, LA 71082-9788

Phone

(318) 519-9034

Fax

(318) 375-2643

NPI assigned

Dec 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Eberhardt Physical Therapy & Wellness Clinic, Inc.

  • Physical Therapist
  • Shreveport, LA
  • NPI 1023202694
  NPD
• Renaissance Solutions, LLC

  • Professional Counselor
  • Lake Charles, LA
  • NPI 1881362572
  NPD

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

{
    "created_epoch": "1576281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576281600000",
    "number": "1386282952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13838 BOYTER LN",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710829788",
            "telephone_number": "318-519-9034",
            "fax_number": "318-375-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 BOYTER LN",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710829788",
            "telephone_number": "318-519-9034",
            "fax_number": "318-375-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELL",
        "first_name": "MARK",
        "credential": "LPC, MA, MAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-14",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "4798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "4798",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lisapt2012@gmail.com",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "other",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Other",
            "address_1": "13838 Boyter Ln",
            "city": "Vivian",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710829788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Trinity Integrate Counseling Solutions, LLC
• Vivian Dental
• Vivian Physical Therapy, Inc.
• Wal-Mart Stores East LP
• Ladarion Washington
• Kathleen West-Clark, M.C.D.
• Kayci Dial Wilson, NURSE PRACTITIONER
• John Woods, MD
• Wright Way Behavioral Health Center
• Andrew Wynn

• All providers in Vivian, LA
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.