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Organization
THE EVOLVING CHAIR COUNSELING AND CONSULTING AGENCY
Active
Organization
THE EVOLVING CHAIR COUNSELING AND CONSULTING AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKIESHA RUSSELL LPC (PRESIDENT/CHILD & FAMILY THERAPIST)
(414) 395-0037
Entity
Organization
Contact information
Practice address
3100 N 78TH ST, MILWAUKEE, WI 53222-3916
(414) 395-0037
Mailing address
7425 W FLORIST AVE, MILWAUKEE, WI 53218-1850
(414) 748-1614
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
6098-125
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6098-125
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6098-125
WI
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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