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General NPI Number Information
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NPI Number | 1275734105
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Entity Type | Individual
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Provider Name | DENISE LOUISE DRUM MSW LCSW SAC
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 407 PILOT CT STE 400
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City | WAUKESHA
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State | WI
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Zip | 53188-2466
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Country | US
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Telephone | 262-524-9822
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Fax | 262-832-0089
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Provider Business Mailing Address
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Address Line | N25W27675 PROSPECT AVE
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City | PEWAUKEE
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State | WI
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Zip | 53072-4361
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12512 - 131
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3079-123
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License Number State | WI
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