Provider Demographics
NPI:1285318832
Name:STUEFEN, DANA (LCSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:STUEFEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11046 W COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4421
Mailing Address - Country:US
Mailing Address - Phone:774-262-4529
Mailing Address - Fax:
Practice Address - Street 1:316 N MILWAUKEE ST STE 401
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-5925
Practice Address - Country:US
Practice Address - Phone:414-522-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9552-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical