Basic Information
| Provider Information | |||||||||
| NPI: | 1518247592 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMPATHETIC COUNSELING SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 806 | ||||||||
| Address2: | |||||||||
| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530080806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4148285617 | ||||||||
| FaxNumber: | 4143322523 | ||||||||
| Practice Location | |||||||||
| Address1: | 4716 W LISBON AVE | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532081127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4148285617 | ||||||||
| FaxNumber: | 4143322523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2011 | ||||||||
| LastUpdateDate: | 08/23/2011 | ||||||||
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| AuthorizedOfficialLastName: | LEWIS | ||||||||
| AuthorizedOfficialFirstName: | TANYA | ||||||||
| AuthorizedOfficialMiddleName: | BROUGHTON | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4148285617 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.