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General NPI Number Information
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NPI Number | 1417312869
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1228 N ASTOR ST
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City | MILWAUKEE
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State | WI
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Zip | 53202-2820
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Country | US
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Telephone | 262-701-7197
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Fax |
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Provider Business Mailing Address
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Address Line | 2181 N 61ST ST
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City | WAUWATOSA
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State | WI
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Zip | 53213-2009
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Country | US
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Telephone | 414-628-3878
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | STEPHANIE J ERBES
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Credential | MA, LPC, NCC
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Telephone | 262-701-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4565-125
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License Number State | WI
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