Provider Demographics
NPI:1538772298
Name:SPAUDE-FILIPCZAK, ALAN MATTHEW (LCSW)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:MATTHEW
Last Name:SPAUDE-FILIPCZAK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15735 W US HIGHWAY 63
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-6475
Mailing Address - Country:US
Mailing Address - Phone:715-934-0710
Mailing Address - Fax:715-598-4881
Practice Address - Street 1:419 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:WI
Practice Address - Zip Code:54891-9452
Practice Address - Country:US
Practice Address - Phone:715-685-8161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13202691657104100000X
WI11329104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker