Paul Brian Zenisek, LCSW

Individual provider Active NPI Clinical Social Worker · Wauwatosa, WI

NPI 1851408751 · NPPES record last updated Dec 4, 2023

Key facts

NPI
1851408751
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
3586-123 (WI)
Practice address
1220 Dewey Ave
Dewey Center
Wauwatosa, WI 53213
Phone
(414) 454-6707
Fax
(414) 454-6747
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3586-123WIMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: pzenisek60978@direct.myadvocateaurora.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3586-123 WI Yes

Addresses

Primary practice location

1220 Dewey Ave
Dewey Center
Wauwatosa, WI 53213

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 454-6707

Other identifiers

IdentifierTypeStateIssuer
40938100MedicaidWI

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address pzenisek60978@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Other providers in Wauwatosa, WI

All providers in Wauwatosa, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.