Provider Demographics
NPI:1841404134
Name:PARCHEM, MITCHELL JAMES (CSAC, ICS)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:JAMES
Last Name:PARCHEM
Suffix:
Gender:M
Credentials:CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S 82ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1434
Mailing Address - Country:US
Mailing Address - Phone:414-431-4720
Mailing Address - Fax:
Practice Address - Street 1:4383 N 27TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1809
Practice Address - Country:US
Practice Address - Phone:414-871-8883
Practice Address - Fax:414-871-8950
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131311101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)