Healthcare Provider Details

I. General information

NPI: 1366871139
Provider Name (Legal Business Name): HAGAR KAUFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4369 S HOWELL AVE STE 306
MILWAUKEE WI
53207-5098
US

IV. Provider business mailing address

9525 W LISBON AVE
MILWAUKEE WI
53222-2529
US

V. Phone/Fax

Practice location:
  • Phone: 414-999-0102
  • Fax:
Mailing address:
  • Phone: 262-606-7761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11599-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: