Healthcare Provider Details

I. General information

NPI: 1528356375
Provider Name (Legal Business Name): SHECAR SUBSSTANCE ABUSE MENTAL HEALTH OUTPATIENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N 4TH ST
MILWAUKEE WI
53212-2362
US

IV. Provider business mailing address

2821 N 4TH ST STE 308
MILWAUKEE WI
53212-2367
US

V. Phone/Fax

Practice location:
  • Phone: 414-372-3903
  • Fax: 414-372-3964
Mailing address:
  • Phone: 414-372-3903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number52D2091836
License Number StateWI
# 6
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHEILA RAMOS
Title or Position: CEO
Credential:
Phone: 414-372-3903