Provider Demographics
NPI:1417185687
Name:ZANOWSKI, STEPHANIE C (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:C
Last Name:ZANOWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:CHADSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:TRANSPLANT SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6400
Mailing Address - Fax:414-955-0213
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:TRANSPLANT SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6400
Practice Address - Fax:414-955-0213
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2925103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1417185687Medicaid
WI1417185687Medicaid
WI736012077Medicare PIN