Provider Demographics
NPI:1992780779
Name:WHELIHAN, WENDY (PHD, LMFT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WHELIHAN
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILLSON RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1332
Mailing Address - Country:US
Mailing Address - Phone:612-695-9266
Mailing Address - Fax:952-926-0402
Practice Address - Street 1:5200 WILLSON RD
Practice Address - Street 2:SUITE 415
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1332
Practice Address - Country:US
Practice Address - Phone:612-695-9266
Practice Address - Fax:952-926-0402
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN051N0WHOtherBLUE CROSS BLUE SHIELD
MN118699OtherHEALTH PARTNERS