Individual
MR. JOSEPH E MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
1220 DEWEY AVE, DEWEY CENTER, WAUWATOSA, WI 53213
(414) 454-6707
(414) 454-6747
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 647-6326
(414) 671-8860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1320-132
WI
101YP2500X
Professional Counselor
2599-125
WI
104100000X
Social Worker
Primary
2461-123
WI
1041C0700X
Clinical Social Worker
2461-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39331000
—
WI
Enumeration date
08/23/2006
Last updated
01/16/2018
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