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 34 days ago.

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