Provider Demographics
NPI:1821405085
Name:MAGES, LINDSEY (CAPSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MAGES
Suffix:
Gender:F
Credentials:CAPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S HOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2743
Mailing Address - Country:US
Mailing Address - Phone:414-290-0028
Mailing Address - Fax:414-481-1433
Practice Address - Street 1:3333 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2743
Practice Address - Country:US
Practice Address - Phone:414-290-0028
Practice Address - Fax:414-481-1433
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127185121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker