Provider Demographics
NPI:1306921440
Name:WENDLICK, CANDACE (LCSW)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:WENDLICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6791 N GREEN BAY AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3422
Mailing Address - Country:US
Mailing Address - Phone:414-228-4800
Mailing Address - Fax:414-247-0894
Practice Address - Street 1:6791 N GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3422
Practice Address - Country:US
Practice Address - Phone:414-228-4800
Practice Address - Fax:414-247-0894
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7057-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical