Healthcare Provider Details

I. General information

NPI: 1467020065
Provider Name (Legal Business Name): WENDY W FAILOR MACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 PARKLAKE DR NE STE 377
ATLANTA GA
30345-2938
US

IV. Provider business mailing address

517 GREENRIDGE CIR
STONE MOUNTAIN GA
30083-4030
US

V. Phone/Fax

Practice location:
  • Phone: 470-229-1052
  • Fax:
Mailing address:
  • Phone: 912-547-9302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: