Individual provider · Type 1 NPI

Kathleen Rose Mack, LCSW

Clinical Social Worker · Glendale, WI

NPI number 1619560992 Active

Practice location

5555 N Port Washington Rd Ste 200
Glendale, WI 53217-4927

Call (262) 789-1191 Map

Mailing address

2459 N 83rd St
Wauwatosa, WI 53213-1024

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X9613-123 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1619560992

Kathleen Rose Mack, LCSW's National Provider Identifier is 1619560992, issued on Feb 17, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Glendale, WI. The record was last updated on Feb 17, 2021.