Provider Demographics
NPI:1871560540
Name:ALBRECHT, ARLIE J (MSSW)
Entity type:Individual
Prefix:MR
First Name:ARLIE
Middle Name:J
Last Name:ALBRECHT
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2793 N 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1156
Mailing Address - Country:US
Mailing Address - Phone:920-737-2035
Mailing Address - Fax:414-616-1736
Practice Address - Street 1:740 PILGRIM PKWY
Practice Address - Street 2:SUITE 206
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2066
Practice Address - Country:US
Practice Address - Phone:414-607-2186
Practice Address - Fax:414-616-1736
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI454124106H00000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39646400Medicaid
WI39646400Medicaid