Individual
CAROL FALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, CADC III
Contact information
Practice address
101 E PIER ST, PORT WASHINGTON, WI 53074-1939
(262) 284-3117
(262) 284-3087
Mailing address
1971 WASHINGTON ST, STE 200, GRAFTON, WI 53024-2125
(262) 377-6276
(262) 377-6289
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11476
WI
104100000X
Social Worker
Primary
2952
WI
1041C0700X
Clinical Social Worker
2952-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40908400
—
WI
Enumeration date
08/01/2006
Last updated
02/06/2019
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