| Tarvid Counseling Llc | |
|
740 Pilgrim Pkwy Suite 103 Elm Grove WI 53122-2066 | |
| (414) 491-0377 | |
| Not Available |
| Full Name | Tarvid Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 740 Pilgrim Pkwy, Elm Grove, Wisconsin |
| Authorized Official Name and Position | Sally S Tarvid (REGISTERED AGENT/MBR) |
| Authorized Official Contact | 4144910377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarvid Counseling Llc 7670 W Honey Creek Pkwy West Allis WI 53219-2738 Ph: (414) 491-0377 | Tarvid Counseling Llc 740 Pilgrim Pkwy Suite 103 Elm Grove WI 53122-2066 Ph: (414) 491-0377 |
| NPI Number | 1386048551 |
|---|---|
| Provider Enumeration Date | 10/17/2014 |
| Last Update Date | 10/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386048551 | NPI | - | NPPES |
| 40967200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7099-123 (Wisconsin) | Primary |
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