Mlodzik, Thomas G

Mlodzik, Thomas G is an sole proprietor health care provider with primary practice located at 2015 E Newport Ave Suite 404, Milwaukee WI 53211-2984. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Mlodzik, Thomas G can be contacted via phone (414) 961-5520.

Contact Information

Primary practice address
2015 E Newport Ave Suite 404 Milwaukee WI 53211-2984
Phone: (414) 961-5520
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12418 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6995-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 555-124 Wisconsin

Profile Details

NPI number 1013017169
LBN Legal business name Mlodzik, Thomas G
Credentials MSW, LCSW, LMFT, CAD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Nov 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013017169 NPPES
Wisconsin Other 12418 CADCIII
Wisconsin MEDICAID 39757800 CADCIII
Wisconsin Other 6995-123 CADCIII
Wisconsin Other 555-124 CADCIII

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