Provider Demographics
NPI:1790022077
Name:MINGESZ, SUSAN N (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:N
Last Name:MINGESZ
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 1:2424 S 90TH ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2455
Mailing Address - Country:US
Mailing Address - Phone:414-329-5657
Mailing Address - Fax:414-329-5637
Practice Address - Street 1:2424 S 90TH ST
Practice Address - Street 2:SUITE 502
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2455
Practice Address - Country:US
Practice Address - Phone:414-329-5657
Practice Address - Fax:414-329-5637
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1663-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical