Healthcare Provider Details

I. General information

NPI: 1093738346
Provider Name (Legal Business Name): WILLIAM HANEL MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 S 76TH ST STE 106
GREENFIELD WI
53220-4300
US

IV. Provider business mailing address

2827 W MCKINLEY BLVD
MILWAUKEE WI
53208-2928
US

V. Phone/Fax

Practice location:
  • Phone: 414-248-3087
  • Fax: 414-762-9727
Mailing address:
  • Phone: 414-248-3087
  • Fax: 262-641-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7244-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: