Healthcare Provider Details

I. General information

NPI: 1669646295
Provider Name (Legal Business Name): SYLVIA CORTEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 W WATERTOWN PLANK RD
MILWAUKEE WI
53226-3559
US

IV. Provider business mailing address

9455 W WATERTOWN PLANK RD
MILWAUKEE WI
53226-3559
US

V. Phone/Fax

Practice location:
  • Phone: 414-257-7222
  • Fax: 414-454-4201
Mailing address:
  • Phone: 414-257-7222
  • Fax: 414-454-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149012815
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: