Provider Demographics
NPI:1437461522
Name:WERTHMANN, IRENE ARLETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:ARLETTE
Last Name:WERTHMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ARLETTE
Other - Middle Name:
Other - Last Name:WERTHMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:411 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-3827
Mailing Address - Country:US
Mailing Address - Phone:972-923-2440
Mailing Address - Fax:972-923-2445
Practice Address - Street 1:411 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-3827
Practice Address - Country:US
Practice Address - Phone:972-923-2440
Practice Address - Fax:972-923-2445
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208316401Medicaid