Healthcare Provider Details

I. General information

NPI: 1467065110
Provider Name (Legal Business Name): MARY LAWINGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5429 TREMPEALEAU TRL
MADISON WI
53705-4662
US

IV. Provider business mailing address

5429 TREMPEALEAU TRL
MADISON WI
53705-4662
US

V. Phone/Fax

Practice location:
  • Phone: 563-513-8038
  • Fax:
Mailing address:
  • Phone: 563-513-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9734-123
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.021265
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: