Provider Demographics
NPI:1902515554
Name:BRIN, KITTY YC (LCSW)
Entity type:Individual
Prefix:
First Name:KITTY
Middle Name:YC
Last Name:BRIN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 N FIELDING RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2429
Mailing Address - Country:US
Mailing Address - Phone:213-300-0069
Mailing Address - Fax:
Practice Address - Street 1:8745 N FIELDING RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-2429
Practice Address - Country:US
Practice Address - Phone:213-300-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12171-1231041C0700X
WI134031-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical