National Provider Identifier Database

MICHAEL A DEFAZIO, MSSW LICSW CADC III – NPI #1154407419
Social Worker

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.


Contact Information

MICHAEL A DEFAZIO, MSSW LICSW CADC III
3734 7TH AVE
STE 24
KENOSHA, WI53140
Phone: 262-654-0487
Fax: 262-654-2434
Website:
Specialty Taxonomy Code
* Social Worker 104100000X
Addiction (Substance Use Disorder) 101YA0400X

* Indicates primary specialty

NPI Profile & details for MICHAEL A DEFAZIO

NPI Number 1154407419
Credentials MSSW LICSW CADC III
Entity Individual
Enumeration date 10/30/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 No
Identifiers
  • WI License #: 044
  • WI License #: 1165
  • WI Medicaid: 39548700
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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