Provider Demographics
NPI:1871220228
Name:STATHOS, WENDY (LPC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:STATHOS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 W POINT PIKE STE 115
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5613
Mailing Address - Country:US
Mailing Address - Phone:215-821-9537
Mailing Address - Fax:
Practice Address - Street 1:1816 W POINT PIKE STE 115
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5613
Practice Address - Country:US
Practice Address - Phone:215-821-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional