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General NPI Number Information
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NPI Number | 1083334429
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Entity Type | Organization
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Legal Business Name | NORTH STAR CONSULTATION LLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 3900 W BROWN DEER RD STE A228
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City | MILWAUKEE
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State | WI
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Zip | 53209-1220
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Country | US
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Telephone | 260-403-7768
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 W BROWN DEER RD STE A228
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City | MILWAUKEE
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State | WI
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Zip | 53209-1220
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Country | US
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Telephone | 260-403-7768
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA KELLY
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Credential | MSW
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Telephone | 414-751-0033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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