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General NPI Number Information
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NPI Number | 1154663375
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC.
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1850 CRANSTON RD
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City | BELOIT
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State | WI
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Zip | 53511-2544
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Country | US
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Telephone | 833-420-1103
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Fax | 608-752-9788
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Provider Business Mailing Address
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Address Line | 6737 W WASHINGTON ST STE 2275
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City | WEST ALLIS
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State | WI
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Zip | 53214-5666
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Country | US
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Telephone | 414-246-2300
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | TARA TREGLOWNE
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Credential |
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Telephone | 414-246-2300
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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 | 2872
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2872
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License Number State | WI
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