Healthcare Provider Details

I. General information

NPI: 1104066893
Provider Name (Legal Business Name): DEBRA ANN MILLMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 HILL STREET SUITE 270
MADISON WI
53705-7364
US

IV. Provider business mailing address

2583 FAHEY GLEN
FITCHBURG WI
53711-9400
US

V. Phone/Fax

Practice location:
  • Phone: 608-802-7739
  • Fax: 608-338-0032
Mailing address:
  • Phone: 608-802-7739
  • Fax: 608-338-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4177-125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4177-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: