Healthcare Provider Details

I. General information

NPI: 1871560540
Provider Name (Legal Business Name): ARLIE J ALBRECHT MSSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 PILGRIM PKWY SUITE 206
ELM GROVE WI
53122-2066
US

IV. Provider business mailing address

2793 N 71ST ST
MILWAUKEE WI
53210-1156
US

V. Phone/Fax

Practice location:
  • Phone: 414-607-2186
  • Fax: 414-616-1736
Mailing address:
  • Phone: 920-737-2035
  • Fax: 414-616-1736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number454124
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: