Provider Demographics
NPI:1982741161
Name:BIANCHINI, WENDY MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:BIANCHINI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HAGGERTY LN STE 2
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-1780
Mailing Address - Country:US
Mailing Address - Phone:406-570-7940
Mailing Address - Fax:
Practice Address - Street 1:333 HAGGERTY LN STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-1780
Practice Address - Country:US
Practice Address - Phone:406-570-7940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1079101YP2500X
MTLCPC-1079101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT740760OtherBLUE CROSSBLUE SHIELD
MT0255749Medicaid