Provider Demographics
NPI:1932397528
Name:CINDY MILNER CLINIC
Entity Type:Organization
Organization Name:CINDY MILNER CLINIC
Other - Org Name:MILNER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:VEE
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-278-8513
Mailing Address - Street 1:1228 E BRADY ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202
Mailing Address - Country:US
Mailing Address - Phone:414-278-8513
Mailing Address - Fax:414-278-0726
Practice Address - Street 1:1228 E BRADY ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202
Practice Address - Country:US
Practice Address - Phone:414-278-8513
Practice Address - Fax:414-278-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22701231041C0700X
WI2270-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42127700Medicaid