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General NPI Number Information
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NPI Number | 1043794324
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Entity Type | Individual
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Provider Name | JOHN MICHAEL DUFFEY LPC
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Gender | Male
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | CHILD & FAMILY THERAPEUTIC SYSTEMS 4811 S 76 STREET #305
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City | GREENFIELD
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State | WI
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Zip | 53220-4364
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Country | US
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Telephone | 414-325-7741
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53213-3723
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Country | US
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Telephone | 414-248-6502
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7094-125
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License Number State | WI
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