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General NPI Number Information
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NPI Number | 1922174291
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Entity Type | Organization
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Legal Business Name | WISCONSIN LUTHERAN CHILD & FAMILY SERVICE, INC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 9555 S HOWELL AVE SUITE 750
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City | OAK CREEK
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State | WI
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Zip | 53154-5000
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Country | US
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Telephone | 414-768-9979
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Fax | 414-768-9981
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Provider Business Mailing Address
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Address Line | 9555 S HOWELL AVE SUITE 750
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City | OAK CREEK
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State | WI
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Zip | 53154-5000
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Country | US
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Telephone | 414-768-9979
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Fax | 414-768-9981
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Authorized Official
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Title or Position | INSURANCE PROVIDER COORDINATOR
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Name | LINDA M RANGEL
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Credential |
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Telephone | 414-358-7812
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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 | 1967-123
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License Number State | WI
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