Healthcare Provider Details

I. General information

NPI: 1346821543
Provider Name (Legal Business Name): LINDA CHAPLIN LCSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA FORSTER

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S 76TH ST STE 240
MILWAUKEE WI
53214-1599
US

IV. Provider business mailing address

3770 N 97TH ST
MILWAUKEE WI
53222-2629
US

V. Phone/Fax

Practice location:
  • Phone: 414-292-4242
  • Fax:
Mailing address:
  • Phone: 262-951-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11159-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: