Provider Demographics
NPI:1932297017
Name:LAUWASSER BRUETT, JUDY (LCSW)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:LAUWASSER BRUETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:LAUWASSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16535 W BLUEMOUND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5906
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:262-544-6377
Practice Address - Street 1:16535 W BLUEMOUND RD STE 200
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5906
Practice Address - Country:US
Practice Address - Phone:262-789-1191
Practice Address - Fax:414-359-1021
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3325-1231041C0700X
WI3325123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker