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Provider Information for 1851864029


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DANIEL CHADWICK MS, LPC, NBCC


Sex: Male

NPI: 1851864029
Last Updated: 2023-08-25
Certification Date: 2023-08-25

Details

NameValue
NPI1851864029
Enumeration Date2019-01-09
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 741 N GRAND AVE STE 204
WAUKESHA, WI 53186-4841
United States

Phone: 262-299-6755 | Fax:
 
Primary Practice Address 2607 N GRANDVIEW BLVD STE 164
WAUKESHA, WI 53188-1686
United States

Phone: 262-299-6755 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)WI18517
No 101YP2500X - Counselor - ProfessionalWI3942-226
Yes 101Y00000X - Counselor WI7748