Wendi Acklen Wood, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1205 Issued in MS

Practice address

12337 Ashley Dr Ste C
Gulfport, MS 39503-2753

Phone

(601) 460-0191

Fax

(601) 336-0968

NPI assigned

May 20, 2013

Last updated

Oct 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 10, 2024 through Mar 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Clinic, Therapy & Consulting LLC

  • Professional Counselor
  • Gulfport, MS
  • NPI 1184108276
  NPD Authorized official

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1821434606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2582",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395052582",
            "telephone_number": "601-460-0191",
            "fax_number": "601-336-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12337 ASHLEY DR STE C",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032753",
            "telephone_number": "601-460-0191",
            "fax_number": "601-336-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "WENDI",
        "middle_name": "ACKLEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric H Wolfson, MD
• Rebecca Womack, PCMHT
• Woman's Clinic, P.a.
• Benjamin Wood, SWMFT
• Charles G Wood, D.M.D.
• Amanda R Woodcock, CNP
• Thai Thao Woodcock, CSFA
• Jillian N Woodland, LCSW
• Amanda Woodruff, MS, RD, LD
• Danelle Woods, PCMHT

• Professional Counselor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.