MEDICARE: MS. PAMELA K SCHIEFFER CSAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	17147132	WI
2	104100000X	Social Worker	135156121	WI

General Provider Information

NPI Number	:	1235951286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAMELA K SCHIEFFER CSAC

Provider Business Mailing Address
First Line	:	5219 W HOWARD AVE APT 4
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53220-2067
Country	:	US
Telephone Number	:	414-935-8086
Fax Number	:

Provider Business Practice Location Address
First Line	:	3910 W LISBON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1834
Country	:	US
Telephone Number	:	414-455-0672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	10/30/2024

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