Healthcare Provider Details

I. General information

NPI: 1386479244
Provider Name (Legal Business Name): ALLAMONTE PERINE JR. MS. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W CAPITOL DR
MILWAUKEE WI
53216-2530
US

IV. Provider business mailing address

7251 W APPLETON AVE APT 1
MILWAUKEE WI
53216-1953
US

V. Phone/Fax

Practice location:
  • Phone: 414-316-8873
  • Fax:
Mailing address:
  • Phone: 414-316-8873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12834-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: