Provider Demographics
NPI:1275734105
Name:DRUM, DENISE LOUISE (MSW LCSW SAC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LOUISE
Last Name:DRUM
Suffix:
Gender:F
Credentials:MSW LCSW SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N25W27675 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-4361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:407 PILOT CT STE 400
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-2466
Practice Address - Country:US
Practice Address - Phone:262-524-9822
Practice Address - Fax:262-832-0089
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12512 - 131101YA0400X
WI3079-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)