Healthcare Provider Details

I. General information

NPI: 1962678466
Provider Name (Legal Business Name): CURRENT INITIATIVES COUNSELING SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 W CAPITOL DR #311
MILWAUKEE WI
53216-2070
US

IV. Provider business mailing address

6815 W CAPITOL DR #311
MILWAUKEE WI
53216-2070
US

V. Phone/Fax

Practice location:
  • Phone: 414-616-8805
  • Fax: 414-616-2296
Mailing address:
  • Phone: 414-616-8805
  • Fax: 414-616-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2491
License Number StateWI

VIII. Authorized Official

Name: MRS. LASHAWNDA DAVIS
Title or Position: DIRECTOR
Credential: PSYCHOTHERAPIST
Phone: 414-616-8805