Provider Demographics
NPI:1649677154
Name:NICOLE V ZELLNER, LLC
Entity type:Organization
Organization Name:NICOLE V ZELLNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:V
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, SAC
Authorized Official - Phone:414-522-1250
Mailing Address - Street 1:930 E KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2896
Mailing Address - Country:US
Mailing Address - Phone:608-385-8147
Mailing Address - Fax:
Practice Address - Street 1:930 E KNAPP ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2896
Practice Address - Country:US
Practice Address - Phone:414-522-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7751-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty