Provider Demographics
NPI:1568057701
Name:NEUMAN, BENJAMIN WADE (MSW)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:WADE
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 S UNIVERSITY AVE APT 15
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-3130
Mailing Address - Country:US
Mailing Address - Phone:561-331-0498
Mailing Address - Fax:
Practice Address - Street 1:9000 W WISCONSIN AVE STE 240
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-337-3400
Practice Address - Fax:414-337-3409
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568057701Medicaid