MEDICARE: MICHELLE MARIE STEADMAN 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	15916-132	WI

General Provider Information

NPI Number	:	1770922056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARIE STEADMAN CSAC

Provider Business Mailing Address
First Line	:	10012 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-1338
Country	:	US
Telephone Number	:	414-810-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	10012 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-1338
Country	:	US
Telephone Number	:	414-810-4800
Fax Number	:

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

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	11/30/2022

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