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General NPI Number Information
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NPI Number | 1063964591
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Entity Type | Organization
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Legal Business Name | WISCONSIN LUTHERAN CHILD & FAMILY SERVICES
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 4200 W DOUGLAS AVE
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City | MILWAUKEE
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State | WI
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Zip | 53209-3529
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Country | US
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Telephone | 800-438-1772
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Fax | 262-293-9737
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Provider Business Mailing Address
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Address Line | W175N11120 STONEWOOD DR ATTN: LINDA RANGEL
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City | GERMANTOWN
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State | WI
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Zip | 53022-6511
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Country | US
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Telephone | 800-438-1772
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Fax | 262-293-9737
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | LINDA RANGEL
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Credential |
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Telephone | 262-345-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17655-130
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2449-226
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License Number State | WI
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