Provider Demographics
NPI:1922994938
Name:WARDLAW, WENDY KING (MA LPC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:KING
Last Name:WARDLAW
Suffix:
Gender:X
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11416 GLENN ABBEY WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2664
Mailing Address - Country:US
Mailing Address - Phone:704-849-9041
Mailing Address - Fax:
Practice Address - Street 1:122 CLEBOURNE ST
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-1753
Practice Address - Country:US
Practice Address - Phone:704-931-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional