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Individual

GLENN ZIPPERER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCSW CADC III

Contact information

Practice address
121 W MAIN ST, STE 350, PORT WASHINGTON, WI 53074-1813
(262) 284-8130
(262) 284-8130
Mailing address
PO BOX 994, STE 350, PORT WASHINGTON, WI 53074-0994
(262) 284-8130
(262) 284-8104

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1105
WI
1041C0700X
Clinical Social Worker
2320123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39333800
WI
Enumeration date
10/31/2005
Last updated
09/11/2025
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