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General NPI Number Information
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NPI Number | 1548978281
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Entity Type | Individual
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Provider Name | AMY MICHELE WENDELOWSKI LPC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 110 YE OLDE KINGS HWY
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-4384
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Country | US
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Telephone | 843-663-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 2574 OLD STAKE RD
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City | CHADBOURN
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State | NC
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Zip | 28431-8244
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Country | US
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Telephone | 843-957-5259
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7984
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License Number State | SC
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