Provider Demographics
NPI:1770752156
Name:ELLIOTT, WENDY M (MA, LPCC,)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MA, LPCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 E ALISO ST
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2909
Mailing Address - Country:US
Mailing Address - Phone:805-640-0579
Mailing Address - Fax:
Practice Address - Street 1:206 N SIGNAL ST STE A
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2656
Practice Address - Country:US
Practice Address - Phone:603-355-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health