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NPI Code Detail

MEDICARE: DAVID C POEHLMANN CSAC, LCSW, ICS

MEDICARE:   DAVID C POEHLMANN  CSAC, LCSW, ICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor1364-132WI
21041C0700XClinical Social Worker7853-123WI

General Provider Information

NPI Number : 1124182126
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID C POEHLMANN CSAC, LCSW, ICS
Provider Business Mailing Address
First Line : 2422 N GRANDVIEW BLVD
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-6105
Country : US
Telephone Number : 262-549-6600
Fax Number : 262-549-6698
Provider Business Practice Location Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-999-3495
Fax Number : 262-821-6180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 03/03/2025

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Directions to “ DAVID C POEHLMANN CSAC, LCSW, ICS” Practice Location

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