Provider Demographics
NPI:1598337412
Name:WHALEY, ZOE (LCSW)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:WHALEY
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:S11251 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GREEN
Mailing Address - State:WI
Mailing Address - Zip Code:53588-9775
Mailing Address - Country:US
Mailing Address - Phone:608-433-7323
Mailing Address - Fax:
Practice Address - Street 1:E7995 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SAUK CITY
Practice Address - State:WI
Practice Address - Zip Code:53583-9637
Practice Address - Country:US
Practice Address - Phone:608-469-4349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9354-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical