Healthcare Provider Details

I. General information

NPI: 1245238633
Provider Name (Legal Business Name): THE COUNSELING CENTER OF MILWAUKEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 N HOLTON ST SUITE 400
MILWAUKEE WI
53212-1064
US

IV. Provider business mailing address

4200 N HOLTON ST SUITE 400
MILWAUKEE WI
53212-1064
US

V. Phone/Fax

Practice location:
  • Phone: 414-964-2565
  • Fax: 414-964-0102
Mailing address:
  • Phone: 414-964-2565
  • Fax: 414-964-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberHFS 61.91
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberHFS 61.91
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberHFS 61.91
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberHFS 61.91
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberHFS 61.91
License Number StateWI

VIII. Authorized Official

Name: MS. CATHY ARNEY
Title or Position: VICE PRESIDENT OF CLINICAL SERVICES
Credential: LCSW, LMFT
Phone: 414-271-2565