Provider Demographics
NPI:1740498476
Name:SHUE, TANYA LETTMAN (MS, LMFT, CADC)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:LETTMAN
Last Name:SHUE
Suffix:
Gender:F
Credentials:MS, LMFT, CADC
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:LETTMAN
Other - Last Name:TEMPLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 KESSEL CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-6275
Mailing Address - Country:US
Mailing Address - Phone:608-280-2437
Mailing Address - Fax:
Practice Address - Street 1:49 KESSEL CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-6275
Practice Address - Country:US
Practice Address - Phone:608-280-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11194101YA0400X
WI608124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43563400Medicaid