Basic Information
| Provider Information | |||||||||
| NPI: | 1457527749 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JORANGER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8901 W CAPITOL DR | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532221706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4144631880 | ||||||||
| FaxNumber: | 4144632770 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 W CAPITOL DR | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532221706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4144631880 | ||||||||
| FaxNumber: | 4144632770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 05/06/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 579-123 | WI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.