Individual
THOMAS G MLODZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, LMFT, CAD
Contact information
Practice address
2015 E NEWPORT AVE, SUITE 404, MILWAUKEE, WI 53211-2984
(414) 961-5520
Mailing address
2015 E NEWPORT AVE, SUITE 404, MILWAUKEE, WI 53211-2984
(414) 961-5520
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12418
WI
1041C0700X
Clinical Social Worker
Primary
6995-123
WI
106H00000X
Marriage & Family Therapist
555-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12418
CADCIII
WI
05
—
39757800
—
WI
01
—
555-124
LMFT
WI
01
—
6995-123
LCSW
WI
Enumeration date
09/25/2006
Last updated
11/04/2016
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