MEDICARE: CATHERINE MELESKY DANTE LCSW

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	8003-123	WI

General Provider Information

NPI Number	:	1336501980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MELESKY DANTE LCSW

Provider Business Mailing Address
First Line	:	915 W WISCONSIN AVE # 352
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-2310
Country	:	US
Telephone Number	:	414-522-5232
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 W WISCONSIN AVE # 352
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-2310
Country	:	US
Telephone Number	:	414-522-5232
Fax Number	:

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

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	03/23/2016

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