Healthcare Provider Details

I. General information

NPI: 1053882373
Provider Name (Legal Business Name): ZENA COUNSELING CENTER OF MILWAUKEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2018
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 S HOWELL AVE
MILWAUKEE WI
53207-4421
US

IV. Provider business mailing address

PO BOX 639
THIENSVILLE WI
53092-0639
US

V. Phone/Fax

Practice location:
  • Phone: 844-458-4201
  • Fax: 414-247-9004
Mailing address:
  • Phone: 414-247-9005
  • Fax: 414-247-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: AZIZA O DAHER
Title or Position: OWNER/PRESIDENT
Credential: LPC
Phone: 414-247-9005