MEDICARE: KATHRYN ELIZABETH SEMENAK LCSW, SAC-IT

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	1041C0700X	Clinical Social Worker	11937123	WI

General Provider Information

NPI Number	:	1295545762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ELIZABETH SEMENAK LCSW, SAC-IT

Provider Business Mailing Address
First Line	:	9542 S FAIRWAY CIR
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-8851
Country	:	US
Telephone Number	:	262-312-0709
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 N JEFFERSON ST STE 408
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-3875
Country	:	US
Telephone Number	:	414-207-6425
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/24/2025

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