Healthcare Provider Details

I. General information

NPI: 1174000764
Provider Name (Legal Business Name): AIMEE M METZGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 EASTWOOD DR STE 300
MADISON WI
53704-5387
US

IV. Provider business mailing address

2010 EASTWOOD DR STE 300
MADISON WI
53704-5387
US

V. Phone/Fax

Practice location:
  • Phone: 608-509-9287
  • Fax: 608-630-8089
Mailing address:
  • Phone: 608-509-9287
  • Fax: 608-630-8089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8882-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: