Provider Demographics
NPI:1023397312
Name:BLEVINS, WENDY (PCC, NCC, LCDC-III)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:PCC, NCC, LCDC-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4044 BROKEN ARROW CT
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-3330
Mailing Address - Country:US
Mailing Address - Phone:850-374-0206
Mailing Address - Fax:
Practice Address - Street 1:4044 BROKEN ARROW CT
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3330
Practice Address - Country:US
Practice Address - Phone:850-374-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25753101YM0800X
OHE.0007747101YP2500X
KY0994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health