Provider Demographics
NPI:1316710890
Name:MULLOOLY, WILLIAM P (APSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:MULLOOLY
Suffix:
Gender:M
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 N 10TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1472
Mailing Address - Country:US
Mailing Address - Phone:414-765-0606
Mailing Address - Fax:
Practice Address - Street 1:1004 N 10TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1472
Practice Address - Country:US
Practice Address - Phone:414-765-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WISW610104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker