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General NPI Number Information
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NPI Number | 1265673412
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Entity Type | Organization
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Legal Business Name | EW COUNSELING, INC.
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 5407 8TH AVE
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City | KENOSHA
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State | WI
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Zip | 53140-3715
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Country | US
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Telephone | 262-412-0670
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Fax |
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Provider Business Mailing Address
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Address Line | 5407 8TH AVE
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City | KENOSHA
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State | WI
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Zip | 53140-3715
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Country | US
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Telephone | 262-412-0670
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. EILEEN G. WARREN
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Credential | CSAC, ICS
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Telephone | 262-412-0670
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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 | 11581-134
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2106-132
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License Number State | WI
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