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NPI Code Detail

MEDICARE: MARK ANDREW MILAEGER

MEDICARE: MARK ANDREW MILAEGER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor18591-130WI
2101YP2500XProfessional Counselor11221-125WI

General Provider Information

NPI Number : 1932690997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK ANDREW MILAEGER
Provider Business Mailing Address
First Line : 525 S 65TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53214-1725
Country : US
Telephone Number : 262-617-6899
Fax Number :
Provider Business Practice Location Address
First Line : 1220 DEWEY AVE # 11
Second Line :
City : WAUWATOSA
State : WI
Zip : 53213-2504
Country : US
Telephone Number : 833-528-7672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2018
Last Update Date : 01/07/2026

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