Roxanne Marie Guenther, LCSW, SASA

Individual provider Active NPI Clinical Social Worker · Elm Grove, WI

NPI 1235124173 · NPPES record last updated Feb 8, 2019

Key facts

NPI
1235124173
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
7037-123 (WI)
Practice address
12970 W Bluemound Rd
Suite 308
Elm Grove, WI 53122-2607
Phone
(262) 780-1020
Fax
(262) 780-1022
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
13082WIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13082 WI
Clinical Social Worker 1041C0700X 7037-123 WI Yes

Addresses

Primary practice location

12970 W Bluemound Rd
Suite 308
Elm Grove, WI 53122-2607

Mailing address

12970 W Bluemound Rd Ste 200
Elm Grove, WI 53122-2607
Phone (262) 780-1020

Other identifiers

IdentifierTypeStateIssuer
13082OtherWICADC-D
7037-123OtherWILCSW
40949900MedicaidWI

Other providers in Elm Grove, WI

All providers in Elm Grove, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.