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General NPI Number Information
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NPI Number | 1801776695
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Entity Type | Individual
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Provider Name | LA-SHAUNA S WINT-POWELL
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 620 S 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53214-1599
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Country | US
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Telephone | 414-292-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 6462 N FRESNO ST
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City | MILWAUKEE
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State | WI
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Zip | 53224-5347
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Country | US
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Telephone | 414-426-6310
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 132345-121
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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 | 12669-123
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License Number State | WI
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