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General NPI Number Information
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NPI Number | 1639776941
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Entity Type | Individual
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Provider Name | PHILLIP D HOWELL LPC-IT
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Gender | Male
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 2222 N MAYFAIR RD STE 120
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City | WAUWATOSA
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State | WI
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Zip | 53226-2262
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Country | US
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Telephone | 414-939-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 12201 W BURLEIGH ST STE 11
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City | WAUWATOSA
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State | WI
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Zip | 53222-3102
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Country | US
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Telephone | 262-345-7421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4234-226
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License Number State | WI
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