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Organization
PORTIS MARRIAGE AND CHILDREN COUNSELING CLINIC, LLC
Active
Organization
PORTIS MARRIAGE AND CHILDREN COUNSELING CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE FAYE PORTIS-PATTERSON MSW, LPC (CLINICAL DIRECTOR/THERAPIST)
(262) 884-9734
Entity
Organization
Contact information
Practice address
5801 WASHINGTON AVE STE 103, RACINE, WI 53406-4057
(262) 884-9734
(262) 884-9735
Mailing address
5801 WASHINGTON AVE STE 110, RACINE, WI 53406-4057
(262) 884-9734
(262) 884-9735
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
947-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39228200
—
WI
Enumeration date
03/05/2008
Last updated
02/15/2011
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