Healthcare Provider Details

I. General information

NPI: 1497674410
Provider Name (Legal Business Name): NICOLE VOYTOVICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 N PROSPECT AVE STE 304
MILWAUKEE WI
53202-6306
US

IV. Provider business mailing address

777 N JEFFERSON ST SUITE 408, PMB 1311
MILWAUKEE WI
53202
US

V. Phone/Fax

Practice location:
  • Phone: 414-405-0670
  • Fax:
Mailing address:
  • Phone: 715-219-1317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9165-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: