Individual
MR. LEE KONCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
16535 W BLUEMOUND RD, 200, BROOKFIELD, WI 53005-5936
(262) 542-3255
(262) 821-6180
Mailing address
5416 MANSFIELD DR, GREENDALE, WI 53129-1354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12275
WI
1041C0700X
Clinical Social Worker
Primary
632123
WI
1041S0200X
School Social Worker
—
WI
Other
Enumeration date
08/05/2006
Last updated
02/13/2008
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