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General NPI Number Information
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NPI Number | 1851142178
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Entity Type | Organization
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Legal Business Name | CREAM CITY COUNSELING LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 219 W MOUNT ROYAL RD
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City | GLENDALE
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State | WI
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Zip | 53217-3907
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Country | US
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Telephone | 414-235-7173
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Fax |
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Provider Business Mailing Address
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Address Line | 4738 N 20TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53209-6345
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Country | US
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Telephone | 414-235-7173
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA DANSBY
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Credential | LPC
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Telephone | 262-989-2627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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