Provider Demographics
NPI:1407683980
Name:JOHNSON, WENDY (LSW)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WEST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-2563
Mailing Address - Country:US
Mailing Address - Phone:412-461-4100
Mailing Address - Fax:412-461-7121
Practice Address - Street 1:1800 WEST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-2563
Practice Address - Country:US
Practice Address - Phone:412-461-4100
Practice Address - Fax:412-461-7121
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health