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General NPI Number Information
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NPI Number | 1891011565
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Entity Type | Organization
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Legal Business Name | ADVANCED SOLUTIONS COUNSELING & THERAPY INC
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 441 MILWAUKEE AVE 1F
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City | BURLINGTON
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State | WI
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Zip | 53105-1230
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Country | US
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Telephone | 262-342-4357
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Fax | 262-554-0124
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Provider Business Mailing Address
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Address Line | 441 MILWAUKEE AVE 1F
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City | BURLINGTON
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State | WI
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Zip | 53105-1230
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Country | US
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Telephone | 262-342-4357
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Fax | 262-554-0124
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Authorized Official
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Title or Position | PRESIDENT, PSYCHOTHERAPIST
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Name | TRIA BRAUN
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Credential | MSW, LCSW
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Telephone | 262-342-4357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7551-123
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License Number State | WI
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