=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376334219
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE SHERKOW LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2025
-----------------------------------------------------
Last Update Date | 05/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 619 W WALNUT ST
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53212-3839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-810-3548
-----------------------------------------------------
Fax | 414-266-3735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7533 N BELL RD
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53217-3518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-403-3153
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 6753-125
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------