Provider Demographics
NPI:1699068015
Name:ZELLNER, NICOLE V (LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:V
Last Name:ZELLNER
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 1:930 E KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2896
Mailing Address - Country:US
Mailing Address - Phone:608-385-8147
Mailing Address - Fax:
Practice Address - Street 1:930 E KNAPP ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2896
Practice Address - Country:US
Practice Address - Phone:414-522-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical