Healthcare Provider Details

I. General information

NPI: 1700700960
Provider Name (Legal Business Name): VERITAS CLINICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 RIVERFRONT DR STE G10A
SHEBOYGAN WI
53081-4629
US

IV. Provider business mailing address

504 SOUTHTOWNE DR APT Y203
SOUTH MILWAUKEE WI
53172-4184
US

V. Phone/Fax

Practice location:
  • Phone: 414-249-1273
  • Fax:
Mailing address:
  • Phone: 414-249-1273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: REYNALDO ORTIZ-MALDONADO
Title or Position: MANAGING MEMBER
Credential: LCSW
Phone: 414-249-1273