Healthcare Provider Details

I. General information

NPI: 1225282478
Provider Name (Legal Business Name): ADVANCED WORKFORCE INITIATIVES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 ODANA RD SUITE 104
MADISON WI
53719-1240
US

IV. Provider business mailing address

5555 ODANA RD SUITE 104
MADISON WI
53719-1240
US

V. Phone/Fax

Practice location:
  • Phone: 608-237-6317
  • Fax:
Mailing address:
  • Phone: 608-237-6317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4122-125
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4122-125
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number4122-125
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4122-125
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number4122-125
License Number StateWI
# 7
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CALVIN L SMITH
Title or Position: PRESIDENT
Credential: LPC
Phone: 608-237-6317