Healthcare Provider Details

I. General information

NPI: 1124161880
Provider Name (Legal Business Name): JULIE MARIE MAYHEW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5007 S HOWELL AVE STE 350
MILWAUKEE WI
53207-6159
US

IV. Provider business mailing address

5007 S HOWELL AVE STE 350
MILWAUKEE WI
53207-6159
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax: 414-962-4052
Mailing address:
  • Phone: 262-999-3495
  • Fax: 414-962-4052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12771-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: