Provider Demographics
NPI:1447718952
Name:HAAS, WENDY LOUISA (LCPC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LOUISA
Last Name:HAAS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 W BELLE PLAINE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3004
Mailing Address - Country:US
Mailing Address - Phone:312-890-2422
Mailing Address - Fax:
Practice Address - Street 1:2118 W BELLE PLAINE AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3004
Practice Address - Country:US
Practice Address - Phone:312-890-2422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180013766101YP2500X
IL1447718952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional