Provider Demographics
NPI:1336800820
Name:GIULIANI, LEAH RENEE (CSW, MSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:RENEE
Last Name:GIULIANI
Suffix:
Gender:F
Credentials:CSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14259 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN
Mailing Address - State:WI
Mailing Address - Zip Code:54149-9713
Mailing Address - Country:US
Mailing Address - Phone:715-850-1403
Mailing Address - Fax:
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI788144104100000X
WI13240-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13240-120OtherSOCIAL WORK
WI788144Medicaid