MEDICARE: DR. STEPHANIE CHUKWUMA DOCTOR OF COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	363AM0700X	Medical Physician Assistant	WI
2	171M00000X	Case Manager/Care Coordinator	WI
3	101YP1600X	Pastoral Counselor	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376193136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE CHUKWUMA DOCTOR OF COUNSELING

Provider Business Mailing Address
First Line	:	PO BOX 16464
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-0464
Country	:	US
Telephone Number	:	414-246-7550
Fax Number	:	414-982-1335

Provider Business Practice Location Address
First Line	:	6114 W CAPITOL DR STE 101
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2147
Country	:	US
Telephone Number	:	414-246-7550
Fax Number	:	414-982-1335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	12/30/2025

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