MEDICARE: MS. BETH ANN WANKE MSW, LCSW, CSAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	15712-132	WI
2	1041C0700X	Clinical Social Worker	8228-123	WI

General Provider Information

NPI Number	:	1225350903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH ANN WANKE MSW, LCSW, CSAC

Provider Business Mailing Address
First Line	:	8602 N 63RD ST
Second Line	:
City	:	BROWN DEER
State	:	WI
Zip	:	53223-2816
Country	:	US
Telephone Number	:	414-507-4507
Fax Number	:

Provider Business Practice Location Address
First Line	:	8602 N 63RD ST
Second Line	:
City	:	BROWN DEER
State	:	WI
Zip	:	53223-2816
Country	:	US
Telephone Number	:	414-507-4507
Fax Number	:

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

Provider Enumeration Date	:	02/22/2010
Last Update Date	:	02/02/2026

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