Provider Demographics
NPI:1396638268
Name:PERNANKIL, AVENASH (MSW, APSW)
Entity type:Individual
Prefix:
First Name:AVENASH
Middle Name:
Last Name:PERNANKIL
Suffix:
Gender:M
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1808
Mailing Address - Country:US
Mailing Address - Phone:608-356-9055
Mailing Address - Fax:608-268-9780
Practice Address - Street 1:2702 INTERNATIONAL LN STE 102
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3117
Practice Address - Country:US
Practice Address - Phone:608-405-5712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135486104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker