Organization
ALAN SUMWALT PSYCHOTHERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN W SUMWALT MSW, LCSW, LMFT (DIRECTOR)
(414) 588-6452
Entity
Organization
Contact information
Practice address
146 PARK AVE, PEWAUKEE, WI, PEWAUKEE, WI 53072-3410
(414) 588-6452
(262) 691-3005
Mailing address
146 PARK AVE, PEWAUKEE, WI, PEWAUKEE, WI 53072-3410
(414) 588-6452
(262) 691-3005
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
346-123
WI
261QM0850X
Adult Mental Health Clinic/Center
346-123
WI
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
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