Provider Demographics
NPI:1700963352
Name:LOESCHER, JANELL M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANELL
Middle Name:M
Last Name:LOESCHER
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 1:5000 W CHAMBERS ST
Mailing Address - Street 2:POB - SUITE 210
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1650
Mailing Address - Country:US
Mailing Address - Phone:414-874-1171
Mailing Address - Fax:414-874-1177
Practice Address - Street 1:5000 W CHAMBERS ST
Practice Address - Street 2:POB - SUITE 210
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1650
Practice Address - Country:US
Practice Address - Phone:414-874-1171
Practice Address - Fax:414-874-1177
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40984100Medicaid
WI000084044Medicare PIN