Provider Demographics
NPI:1346393287
Name:WINIUS, MICHAEL H (MSW , LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:H
Last Name:WINIUS
Suffix:
Gender:M
Credentials:MSW , LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 S NICOLET ROAD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:ID
Mailing Address - Zip Code:54914-8270
Mailing Address - Country:US
Mailing Address - Phone:920-882-6610
Mailing Address - Fax:920-882-6611
Practice Address - Street 1:477 S NICOLET ROAD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:ID
Practice Address - Zip Code:54914-8270
Practice Address - Country:US
Practice Address - Phone:920-882-6610
Practice Address - Fax:920-882-6611
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6699 1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40920800Medicaid