Provider Demographics
NPI:1811875396
Name:ARTEAGA, CARMEN MARIE (SAC-IT)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIE
Last Name:ARTEAGA
Suffix:
Gender:F
Credentials:SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 W WASHINGTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3142
Mailing Address - Country:US
Mailing Address - Phone:414-243-0122
Mailing Address - Fax:414-243-0122
Practice Address - Street 1:7127 W WASHINGTON ST APT 3
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-3142
Practice Address - Country:US
Practice Address - Phone:414-243-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20873-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty