Provider Demographics
NPI:1467934711
Name:GREENWALD, MERCY M (LCSW)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:M
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 S HIGH POINT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-4926
Mailing Address - Country:US
Mailing Address - Phone:608-826-8011
Mailing Address - Fax:608-826-8027
Practice Address - Street 1:615 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2952
Practice Address - Country:US
Practice Address - Phone:608-826-8010
Practice Address - Fax:608-826-8027
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8665-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical