MEDICARE: WISCONSIN LUTHERAN CHILD & FAMILY SERVICE

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
1	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215380746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISCONSIN LUTHERAN CHILD & FAMILY SERVICE

Provider Business Mailing Address
First Line	:	W175N11120 STONEWOOD DR
Second Line	:
City	:	GERMANTOWN
State	:	WI
Zip	:	53022-6511
Country	:	US
Telephone Number	:	800-438-1772
Fax Number	:	262-293-9737

Provider Business Practice Location Address
First Line	:	3040 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2618
Country	:	US
Telephone Number	:	800-438-1772
Fax Number	:	262-293-9737

Authorized Official
Title or Position	:	CEO
Name	:	MARK KLUG
Credential	:
Telephone Number	:	888-685-9522

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	07/20/2016

Similar Medicare Providers

1639235443 — WEB CAST INDUSTRIES INC.
Practice Location Address:

3008 W CAPITOL DR
MILWAUKEE, WI
53216-2618

Practice Phone: 414-447-6062
Practice Fax: 414-873-9583

1225583313 — AMANDA LEIGH DELONG LCSW
Practice Location Address:

3040 W CAPITOL DR
MILWAUKEE, WI
53216-2618

Practice Phone: 800-438-1772
Practice Fax: 262-293-9737

1790088896 — META HOUSE
Practice Location Address:

2618 N BREMEN ST
MILWAUKEE, WI
53212-3003

Practice Phone: 414-962-1200
Practice Fax: 414-372-9287

1013211895 — JOCELYNN HOSEA-DAVIS M.S.W., S.A.C.I.T.
Practice Location Address:

2618 N BREMEN ST
MILWAUKEE, WI
53212-3003

Practice Phone: 414-977-1200
Practice Fax: 414-962-2305

1093019762 — NICOLE CLARK APSW, CSAC
Practice Location Address:

2618 N BREMEN ST
MILWAUKEE, WI
53212-3003

Practice Phone: 414-977-1200
Practice Fax: 414-962-2305

1710281456 — MICHELE WILLIAMS CSAC, CS-IT
Practice Location Address:

2618 N BREMEN ST
MILWAUKEE, WI
53212-3003

Practice Phone: 414-977-1200
Practice Fax: 414-962-2305

Directions to “WISCONSIN LUTHERAN CHILD & FAMILY SERVICE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.