Provider Demographics
NPI:1962582171
Name:MUCHKA, JOSEPH A (LPC, NCC, CADCIII)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:MUCHKA
Suffix:
Gender:M
Credentials:LPC, NCC, CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 QUAIL CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-3790
Mailing Address - Country:US
Mailing Address - Phone:262-746-1122
Mailing Address - Fax:262-746-1133
Practice Address - Street 1:1177 QUAIL CT
Practice Address - Street 2:SUITE 101
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3790
Practice Address - Country:US
Practice Address - Phone:262-746-1122
Practice Address - Fax:262-746-1133
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2135101YA0400X
WI3082-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional