MEDICARE: MRS. HAGAR KAUFMAN 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	11599-123	WI
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1366871139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HAGAR KAUFMAN LCSW

Provider Business Mailing Address
First Line	:	9525 W LISBON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-2529
Country	:	US
Telephone Number	:	262-606-7761
Fax Number	:

Provider Business Practice Location Address
First Line	:	4369 S HOWELL AVE STE 306
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-5098
Country	:	US
Telephone Number	:	414-999-0102
Fax Number	:

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

Provider Enumeration Date	:	11/02/2013
Last Update Date	:	12/20/2024

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