Provider Demographics
NPI:1902324569
Name:PARADINE, WENDI CAROL (LMSW)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:CAROL
Last Name:PARADINE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 EARNHARDT DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036
Mailing Address - Country:US
Mailing Address - Phone:517-617-3952
Mailing Address - Fax:
Practice Address - Street 1:450 E GRANT ST
Practice Address - Street 2:
Practice Address - City:BRONSON
Practice Address - State:MI
Practice Address - Zip Code:49028
Practice Address - Country:US
Practice Address - Phone:517-369-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010982281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical