Healthcare Provider Details

I. General information

NPI: 1568496701
Provider Name (Legal Business Name): SANDRA A ZYGARLICKI MSW, LCSW, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEMENT J ZABLOCKI V A MEDICAL CTR 5000 W. NATIONAL AVENUE, MAIL CODE: MH-DOM123
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

180 N 93RD ST
MILWAUKEE WI
53226-4401
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax:
Mailing address:
  • Phone: 414-384-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number479-123
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number223-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: