Provider Demographics
NPI:1972522217
Name:HUBER, KAREN ANNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:HUBER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 DEWEY AVE.
Mailing Address - Street 2:AURORA BEHAVIORAL HEALTH
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213
Mailing Address - Country:US
Mailing Address - Phone:414-454-6761
Mailing Address - Fax:414-454-6522
Practice Address - Street 1:1220 DEWEY AVE
Practice Address - Street 2:AURORA BEHAVIORAL HEALTH
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-2504
Practice Address - Country:US
Practice Address - Phone:414-454-6761
Practice Address - Fax:414-454-6522
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1823-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39735300Medicaid
WIR63946Medicare UPIN
WI000284911Medicare PIN