WILLOWGLEN ACADEMY INC NPI 1619147048

NPI Information

  • NPI: 1619147048
  • Provider Name: WILLOWGLEN ACADEMY INC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Other Name: WILLOWGLEN ACADEMY OUTPATIENT CLINIC
  • Address: 4065 N 35TH ST
    SUITE N100
    MILWAUKEE, WI
    ZIP 53216
  • Phone: (414) 445-9180

Map and Directions

Get Directions

NPI Details

WILLOWGLEN ACADEMY INC is a clinic center in Milwaukee, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). WILLOWGLEN ACADEMY INC NPI is 1619147048. The provider is registered as an organization entity type.
The provider Other Name Is Willowglen Academy Outpatient Clinic.

The provider's business location address is:

4065 N 35TH ST
SUITE N100
MILWAUKEE, WI
ZIP 53216-705
Phone: (414) 445-9180
Fax: (414) 445-5995

The provider's authorized official is Shanna Maloney .
The authorized official title is Director Of Outpatient Services and has the following contact phone number (414) 445-9180.

The enumeration date for this NPI number is 2/29/2008 and was last updated on 6/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center2004WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142167200MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI