Individual
MS. MAUREEN R GOLDBLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
(262) 789-1191
(262) 821-6180
Mailing address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
(262) 789-1191
(262) 821-6180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11371-132
WI
101YP2500X
Professional Counselor
Primary
3162-125
WI
101YP2500X
Professional Counselor
E0700276
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40909800
—
WI
Enumeration date
05/27/2008
Last updated
01/15/2025
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