Healthcare Provider Details

I. General information

NPI: 1912239930
Provider Name (Legal Business Name): LISA ANNETTE ADAMS-QUALLS SAC, APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N VEL R PHILLIPS AVE STE 131
MILWAUKEE WI
53212-2370
US

IV. Provider business mailing address

2821 N VEL R PHILLIPS AVE STE 131
MILWAUKEE WI
53212-2370
US

V. Phone/Fax

Practice location:
  • Phone: 414-374-8787
  • Fax: 414-374-8181
Mailing address:
  • Phone: 414-374-8787
  • Fax: 414-374-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16040-131
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128946
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: