Provider Demographics
NPI:1811970205
Name:ALAMILLA, MICHAEL A (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:ALAMILLA
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 1:2021 N 60TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-1641
Mailing Address - Country:US
Mailing Address - Phone:414-771-2881
Mailing Address - Fax:414-541-0063
Practice Address - Street 1:2021 N. 60TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208
Practice Address - Country:US
Practice Address - Phone:414-771-2881
Practice Address - Fax:414-541-0063
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2866123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39296400Medicaid
WI39296400Medicaid