MEDICARE: CATAPULT WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker
3	171M00000X	Case Manager/Care Coordinator
4	251B00000X	Case Management Agency
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
6	261QM0855X	Adolescent and Children Mental Health Clinic/Center
7	261QP0905X	State or Local Public Health Clinic/Center
8	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1982364204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATAPULT WELLNESS LLC

Provider Business Mailing Address
First Line	:	3026 W CONCORDIA AVE STE 100
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3853
Country	:	US
Telephone Number	:	414-253-7494
Fax Number	:	414-296-0273

Provider Business Practice Location Address
First Line	:	3026 W CONCORDIA AVE STE 100
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3853
Country	:	US
Telephone Number	:	414-253-7494
Fax Number	:	414-296-0273

Authorized Official
Title or Position	:	CLINICAL ADMINISTRATOR/CEO
Name	:	ERIKA LYNN BROXTON
Credential	:	APSW
Telephone Number	:	414-253-7494

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	09/28/2023

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Directions to “CATAPULT WELLNESS LLC ” Practice Location

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