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General NPI Number Information
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NPI Number | 1598276719
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Entity Type | Organization
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Legal Business Name | CORE CENTER FOR COUPLES AND THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 10/15/2017
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Last Update Date | 10/15/2017
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Provider Practice Location Address
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Address Line | 10855 W POTTER RD STE 23
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City | WAUWATOSA
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State | WI
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Zip | 53226-3439
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Country | US
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Telephone | 414-214-7326
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Fax |
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Provider Business Mailing Address
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Address Line | 10855 W POTTER RD STE 23
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City | WAUWATOSA
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State | WI
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Zip | 53226-3439
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Country | US
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Telephone | 414-214-7326
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | AMY LEMBERGER
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Credential | MS, LMFT
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Telephone | 414-214-7326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 920-124
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License Number State | WI
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