MEDICARE: WENDY SERKETICH PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2038-57	WI
2	103T00000X	Psychologist	2038057	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225054869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY SERKETICH PHD

Provider Business Mailing Address
First Line	:	5007 S HOWELL AVE STE 350
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-6159
Country	:	US
Telephone Number	:	262-999-3495
Fax Number	:

Provider Business Practice Location Address
First Line	:	5007 S HOWELL AVE STE 350
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-6159
Country	:	US
Telephone Number	:	262-999-3495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	02/16/2026

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