Healthcare Provider Details

I. General information

NPI: 1245335157
Provider Name (Legal Business Name): MARK HUFEN MAPC, LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 S 108TH ST
GREENFIELD WI
53228-2504
US

IV. Provider business mailing address

4455 S 108TH ST
GREENFIELD WI
53228-2504
US

V. Phone/Fax

Practice location:
  • Phone: 414-427-5310
  • Fax: 414-427-5311
Mailing address:
  • Phone: 414-427-5310
  • Fax: 414-427-5311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-006474
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3558-125
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3558
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: