Provider Demographics
NPI:1841207362
Name:CASALI, MICHAEL ANGELO (PHD, MS, LCSW, LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:CASALI
Suffix:
Gender:M
Credentials:PHD, MS, LCSW, LPC
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:ANGELO
Other - Last Name:CASALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LCPC
Mailing Address - Street 1:N112W20945 MEQUON RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-2827
Mailing Address - Country:US
Mailing Address - Phone:608-843-6380
Mailing Address - Fax:
Practice Address - Street 1:2524 E WEBSTER PL
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4256
Practice Address - Country:US
Practice Address - Phone:414-964-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003585101YM0800X
WI1741-125101YM0800X
1041C0700X
WI3349-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health