Individual
MS. MARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W. CAPSW
Contact information
Practice address
1545 S LAYTON BLVD, MILWAUKEE, WI 53215-1924
(414) 902-1500
Mailing address
3830 N 52ND ST, MILWAUKEE, WI 53216-2308
(414) 217-2423
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
WI
101YP2500X
Professional Counselor
Primary
—
WI
104100000X
Social Worker
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40987400
—
WI
Enumeration date
05/04/2007
Last updated
09/11/2025
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