Deacon, Wendolyn
Deacon, Wendolyn is an sole proprietor health care provider with primary practice located at 304 N Horner Blvd , Sanford NC 27330-3939. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Deacon, Wendolyn can be contacted via phone (919) 895-3222.Contact Information
Primary practice address
304 N Horner Blvd
Sanford NC 27330-3939
Phone: (919) 895-3222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 5598 | North Carolina |
Profile Details
| NPI number | 1407016546 |
|---|---|
| LBN Legal business name | Deacon, Wendolyn |
| Credentials | LPCS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2008 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407016546 | NPPES |
| North Carolina | Other | 467375 | MHN (TRICARE) |
| North Carolina | MEDICAID | 6104067 | MHN (TRICARE) |
| North Carolina | Other | 1542V | MHN (TRICARE) |
| North Carolina | Other | 2667979 | MHN (TRICARE) |
| North Carolina | Other | 9367568 | MHN (TRICARE) |
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