Provider Demographics
NPI:1356027452
Name:STAPLIN, NEIL JACOB (LCSW)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:JACOB
Last Name:STAPLIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 S 58TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-5116
Mailing Address - Country:US
Mailing Address - Phone:608-259-6506
Mailing Address - Fax:
Practice Address - Street 1:1603 S 58TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-5116
Practice Address - Country:US
Practice Address - Phone:608-259-6506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9571-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical