Individual provider Active NPI

Wendy Laursen, M.A., LPC, LPCA

  • Professional Counselor
  • Wilmington, NC
National Provider Identifier
1760890339
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A10857 Issued in NC
Practice address
3806 Peachtree Ave Ste 210
Wilmington, NC 28403-6752
Phone
(910) 251-7789
NPI assigned
Jul 28, 2014
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20965 NC
Professional Counselor 101YP2500X A10857 NC Primary

Addresses

Primary practice location

3806 Peachtree Ave Ste 210
Wilmington, NC 28403-6752

Mailing address

33 Pelican Point Rd
Wilmington, NC 28409-3567
Phone (910) 538-4397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
20965NCMDAddiction (Substance Use Disorder) Counselor
A10857NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Live Oak Counseling and Associates PastSince Aug 15, 2021 Accepting new patients
Agape Counseling Associates, Inc Professional Past Accepting new patients
Barbara Ann Jacques PastSince Mar 16, 2021 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1760890339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PELICAN POINT RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093567",
            "telephone_number": "910-538-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 PEACHTREE AVE STE 210",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036752",
            "telephone_number": "910-251-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "WENDY",
        "credential": "M.A., LPC, LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "20965",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A10857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.