MEDICARE: NANCY J RICHTER LCSW, CADCIII

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	1742	WI
2	1041C0700X	Clinical Social Worker		WI

General Provider Information

NPI Number	:	1487857959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY J RICHTER LCSW, CADCIII

Provider Business Mailing Address
First Line	:	W62N248 WASHINGTON AVE
Second Line	:	SUITE #207
City	:	CEDARBURG
State	:	WI
Zip	:	53012-2768
Country	:	US
Telephone Number	:	262-375-1116
Fax Number	:	262-375-1071

Provider Business Practice Location Address
First Line	:	2363 S 102ND ST
Second Line	:	#203
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2143
Country	:	US
Telephone Number	:	414-545-1950
Fax Number	:	414-545-4168

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	09/11/2025

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