Provider Demographics
NPI:1316437734
Name:WILLIAMS-VAN KLOOSTER, BRIT MARIE (MSW, CAPSW)
Entity type:Individual
Prefix:
First Name:BRIT
Middle Name:MARIE
Last Name:WILLIAMS-VAN KLOOSTER
Suffix:
Gender:F
Credentials:MSW, CAPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 E RUSK AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2555
Mailing Address - Country:US
Mailing Address - Phone:414-510-6970
Mailing Address - Fax:
Practice Address - Street 1:1720 W FLORIST AVE STE 125
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3862
Practice Address - Country:US
Practice Address - Phone:414-247-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI126541-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker