Organization
MILWAUKEE CENTER FOR INDEPENDENCE INC
Active
Parent organization
MILWAUKEE CENTER FOR INDEPENDENCE
Other names
Whole Health Clinical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILWAUKEE CENTER FOR INDEPENDENCE
Authorized official
ANDREW MAULE (DIRECTOR OF BUSINESS OPERATIONS)
(608) 692-9495
Entity
Organization
Contact information
Practice address
2020 W WELLS ST, MILWAUKEE, WI 53233-2720
(414) 476-9675
(414) 476-9615
Mailing address
2020 W WELLS ST, MILWAUKEE, WI 53233-2720
(414) 476-9675
(414) 557-1834
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1933
WI
363LF0000X
Family Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42128300
—
WI
01
—
DD9253
RAILROAD MEDICARE PART B
WI
Enumeration date
06/17/2006
Last updated
05/08/2024
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