Provider Demographics
NPI:1619996881
Name:ALBERT, STEPHANY (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:STEPHANY
Other - Middle Name:
Other - Last Name:WISIOL ALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6504 VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2960
Mailing Address - Country:US
Mailing Address - Phone:414-403-1101
Mailing Address - Fax:
Practice Address - Street 1:2000 E LAYTON AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53235-6053
Practice Address - Country:US
Practice Address - Phone:414-482-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7142-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO05191995OtherGRAD DATE UNIV OF MO