Healthcare Provider Details

I. General information

NPI: 1033072111
Provider Name (Legal Business Name): KAITLIN PAIGE WELSH MSW, CAPSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E OLIN AVE STE 100
MADISON WI
53713-1467
US

IV. Provider business mailing address

128 E OLIN AVE STE 100
MADISON WI
53713-1467
US

V. Phone/Fax

Practice location:
  • Phone: 608-252-1320
  • Fax: 608-252-1333
Mailing address:
  • Phone: 608-252-1320
  • Fax: 608-252-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number135418-121
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135418-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: