Organization
CHRISTIAN LIFE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA L GERHARD (CO-OWNER)
(262) 785-1008
Entity
Organization
Contact information
Practice address
12630 W NORTH AVE BLDG E, BROOKFIELD, WI 53005
(262) 785-1008
(262) 432-9059
Mailing address
12630 W NORTH AVE BLDG E, BROOKFIELD, WI 53005-4626
(262) 785-1008
(262) 432-9059
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/03/2006
Last updated
04/09/2020
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