Healthcare Provider Details

I. General information

NPI: 1073601803
Provider Name (Legal Business Name): WENDY GRIFFIN-ALLEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 BEACON ST
FORT WAYNE IN
46805-4750
US

IV. Provider business mailing address

1825 BEACON ST
FORT WAYNE IN
46805-4750
US

V. Phone/Fax

Practice location:
  • Phone: 260-484-4153
  • Fax:
Mailing address:
  • Phone: 260-484-4153
  • Fax: 260-484-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001490A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: