Provider Demographics
NPI:1881752921
Name:PRIGGE, WENDY J (CADC III)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:J
Last Name:PRIGGE
Suffix:
Gender:F
Credentials:CADC III
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC III
Mailing Address - Street 1:836 CRAITE AVENUE
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868
Mailing Address - Country:US
Mailing Address - Phone:715-234-1906
Mailing Address - Fax:
Practice Address - Street 1:410 N RIVER ST
Practice Address - Street 2:AURORA COMM COUNSELING EMPLOYEE SUPPORT & SERVICES DBA
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801
Practice Address - Country:US
Practice Address - Phone:715-635-4858
Practice Address - Fax:715-635-4861
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1234101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39358100Medicaid