Healthcare Provider Details

I. General information

NPI: 1013633460
Provider Name (Legal Business Name): MICHELLE VALENTINA TOCCO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15350 W NATIONAL AVE
NEW BERLIN WI
53151-5158
US

IV. Provider business mailing address

15350 W NATIONAL AVE
NEW BERLIN WI
53151-5158
US

V. Phone/Fax

Practice location:
  • Phone: 262-249-6565
  • Fax:
Mailing address:
  • Phone: 262-249-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12425-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: