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General NPI Number Information
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NPI Number | 1346430303
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Entity Type | Organization
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Legal Business Name | LASHAWNDA R DAVIS CURRENT INITIATIVES COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 6815 W CAPITOL DR ROOM 311
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City | MILWAUKEE
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State | WI
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Zip | 53216-2070
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Country | US
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Telephone | 414-616-8805
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Fax | 414-616-2296
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Provider Business Mailing Address
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Address Line | 6815 W CAPITOL DR ROOM 311
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City | MILWAUKEE
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State | WI
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Zip | 53216-2070
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Country | US
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Telephone | 414-616-8805
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Fax | 414-616-2296
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Authorized Official
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Title or Position | DIRECTOR/PSYCHOTHERAPIST
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Name | MS. LASHAWNDA DAVIS
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Credential | MS, CAPSW
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Telephone | 414-628-5495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 251C00000X
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 39773300
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License Number State | WI
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