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Individual

ROBERT M MCCREADIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSAC, ICS

Contact information

Practice address
5005 UNIVERSITY AVE, MADISON, WI 53705-5439
(608) 233-2100
(608) 233-2101
Mailing address
403 N GRAND AVE, WAUKESHA, WI 53186-4984
(262) 409-5462

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15474131
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15500-132
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497986079
WY
Enumeration date
07/31/2009
Last updated
12/16/2019
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