Provider Demographics
NPI:1750444782
Name:MALEN, CAROLEE SUE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROLEE
Middle Name:SUE
Last Name:MALEN
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 1:759 N MILWAUKEE ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3795
Mailing Address - Country:US
Mailing Address - Phone:414-271-1718
Mailing Address - Fax:414-221-9261
Practice Address - Street 1:759 N MILWAUKEE ST
Practice Address - Street 2:SUITE 600
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-3795
Practice Address - Country:US
Practice Address - Phone:414-271-1718
Practice Address - Fax:414-221-9261
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26041231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical