Mike L Minkin | Milwaukee, WI • PECOS Search

Mike L Minkin

Social Worker

Behavioral Health & Social Service Providers

5000 W National Ave, Milwaukee, WI 53295-0001

PECOS Enrollment

Based on the most recent information from CMS, provider Mike L Minkin does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1215967013
Provider Type
Individual
Full Name
Minkin, Mike L
Title
Mr.
Credential
MSW

Gender
Male
Sole Proprietor
No
Enumeration Date
7/4/2006
Last Updated
7/8/2007

Contact Information

Practice Location

5000 W National Ave, Milwaukee, WI 53295-0001

Unlisted Fax

Mailing Location

165 Heidel Rd, Thiensville, WI 53092-1250

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 2605 - 123 Wisconsin