Healthcare Provider Details

I. General information

NPI: 1386417079
Provider Name (Legal Business Name): MARLENA WENDRICK MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E ELIZABETH AVE STE 208
BETHLEHEM PA
18018-6512
US

IV. Provider business mailing address

517 3RD AVE APT 1
BETHLEHEM PA
18018-5503
US

V. Phone/Fax

Practice location:
  • Phone: 610-320-2366
  • Fax:
Mailing address:
  • Phone: 570-647-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: