Provider Demographics
NPI:1306326418
Name:WENDELIN, JILLIAN MARIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:MARIE
Last Name:WENDELIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 GOLDBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1656
Mailing Address - Country:US
Mailing Address - Phone:702-706-4234
Mailing Address - Fax:
Practice Address - Street 1:3425 CLIFF SHADOWS PKWY STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-5112
Practice Address - Country:US
Practice Address - Phone:702-706-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1043101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health