Healthcare Provider Details

I. General information

NPI: 1962318691
Provider Name (Legal Business Name): MADELINE GLASPEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W156N8327 PILGRIM RD STE 302
MENOMONEE FALLS WI
53051-3776
US

IV. Provider business mailing address

624 E RUSSELL AVE
MILWAUKEE WI
53207-2127
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-1112
  • Fax:
Mailing address:
  • Phone: 414-759-1253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: