Provider Demographics
NPI:1962110593
Name:RAPINCHUK, ANDREW DAVID (LCSW, SAC-IT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:RAPINCHUK
Suffix:
Gender:M
Credentials:LCSW, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 SPRINGDALE RD APT 111
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-2706
Mailing Address - Country:US
Mailing Address - Phone:262-210-0070
Mailing Address - Fax:
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:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9699-1231041C0700X
WI18867-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)