Provider Demographics
NPI:1609945534
Name:MARCHANT, PATRICIA MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 170526
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-8046
Mailing Address - Country:US
Mailing Address - Phone:414-963-9000
Mailing Address - Fax:414-963-9008
Practice Address - Street 1:1110 N OLD WORLD THIRD ST
Practice Address - Street 2:SUITE 401
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-1117
Practice Address - Country:US
Practice Address - Phone:414-224-0800
Practice Address - Fax:414-224-0883
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI16501231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3955300Medicaid
895060002Medicare ID - Type Unspecified