Healthcare Provider Details

I. General information

NPI: 1588598080
Provider Name (Legal Business Name): QUINTIN MICHAEL GAUS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8102 WELLNESS WAY
MADISON WI
53719-8800
US

IV. Provider business mailing address

8102 WELLNESS WAY
MADISON WI
53719-8800
US

V. Phone/Fax

Practice location:
  • Phone: 608-417-8741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11829-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: