Provider Demographics
NPI:1033524111
Name:OBY, ALAYNA (SAC-IT, APSW)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:
Last Name:OBY
Suffix:
Gender:F
Credentials:SAC-IT, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 W HAWTHORNE TRACE RD
Mailing Address - Street 2:APT 207
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1063
Mailing Address - Country:US
Mailing Address - Phone:414-793-6466
Mailing Address - Fax:
Practice Address - Street 1:3900 W BROWN DEER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53209-1220
Practice Address - Country:US
Practice Address - Phone:414-540-2170
Practice Address - Fax:262-242-3816
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129436121104100000X
WI17001-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker