Healthcare Provider Details

I. General information

NPI: 1841102001
Provider Name (Legal Business Name): TRACY DAWN URBAN APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 N PROSPECT AVE
MILWAUKEE WI
53202-6319
US

IV. Provider business mailing address

2266 N PROSPECT AVE
MILWAUKEE WI
53202-6319
US

V. Phone/Fax

Practice location:
  • Phone: 414-322-2907
  • Fax:
Mailing address:
  • Phone: 414-322-2907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136368121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: