Provider Demographics
NPI:1194835447
Name:ALETTHA, WENDY (MSSW LCSW)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:ALETTHA
Suffix:
Gender:F
Credentials:MSSW LCSW
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ALETTHA
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CICSW
Mailing Address - Street 1:122 E OLIN AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713
Mailing Address - Country:US
Mailing Address - Phone:608-255-9119
Mailing Address - Fax:608-255-9219
Practice Address - Street 1:122 E OLIN AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713
Practice Address - Country:US
Practice Address - Phone:608-255-9119
Practice Address - Fax:608-255-9219
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34311231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical