| Children's Service Society Of Wisconsin | |
|
8207 22nd Ave Suite 155 Kenosha WI 53143-6211 | |
| (262) 652-5522 | |
| (262) 652-7228 |
| Full Name | Children's Service Society Of Wisconsin |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8207 22nd Ave, Kenosha, Wisconsin |
| Authorized Official Name and Position | Tracy Oerter (INTERIM DIRECTOR OF COUNSELING) |
| Authorized Official Contact | 4142662912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Service Society Of Wisconsin 8207 22nd Ave Suite 155 Kenosha WI 53143-6211 Ph: (262) 652-5522 | Children's Service Society Of Wisconsin 8207 22nd Ave Suite 155 Kenosha WI 53143-6211 Ph: (262) 652-5522 |
| NPI Number | 1821262684 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 12/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821262684 | NPI | - | NPPES |
| 42210200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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