Individual provider · Type 1 NPI

Mikayla Tidemann, LPC

Mental Health Counselor · Milwaukee, WI

NPI number 1790441665 Active

Practice location

620 S 76th St
Milwaukee, WI 53214-1599

Fax (414) 453-2538

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X10312-125 (WI)

Mental Health Counselor: Definition to come...

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About NPI 1790441665

Mikayla Tidemann, LPC's National Provider Identifier is 1790441665, issued on Nov 15, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Milwaukee, WI. The record was last updated on Apr 22, 2026.