Provider Demographics
NPI:1801434899
Name:MILWAUKEE MIND SOLUTIONS
Entity type:Organization
Organization Name:MILWAUKEE MIND SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PRACHI
Authorized Official - Middle Name:
Authorized Official - Last Name:APOSTOLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-723-5050
Mailing Address - Street 1:3970 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2265
Mailing Address - Country:US
Mailing Address - Phone:224-723-5050
Mailing Address - Fax:224-723-5289
Practice Address - Street 1:3970 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-2265
Practice Address - Country:US
Practice Address - Phone:224-723-5050
Practice Address - Fax:224-723-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3169-57OtherPRIVATE INSURANCE