Healthcare Provider Details

I. General information

NPI: 1487911657
Provider Name (Legal Business Name): MICHELLE M STERLING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 FORDEM AVE
MADISON WI
53704-4604
US

IV. Provider business mailing address

9000 W WISCONSIN AVE # MS 958
MILWAUKEE WI
53226-4874
US

V. Phone/Fax

Practice location:
  • Phone: 608-221-3511
  • Fax: 608-221-3514
Mailing address:
  • Phone: 414-266-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number080162
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8392
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: