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General NPI Number Information
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NPI Number | 1295045557
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Entity Type | Organization
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Legal Business Name | WISCONSIN LUTHERAN CHILD & FAMILY SERVICE
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 1512 S CESAR E CHAVEZ DR
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City | MILWAUKEE
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State | WI
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Zip | 53204-2715
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Country | US
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Telephone | 800-438-1772
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Fax | 262-345-5562
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Provider Business Mailing Address
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Address Line | W175N11120 STONEWOOD DR
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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 | 262-345-5530
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Fax | 262-345-5531
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Authorized Official
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Title or Position | INSURANCE PROVIDER COORDINATOR
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Name | LINDA M 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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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