Organization
MWA COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WESTRATE MA, LPC (TREASURER)
(262) 554-1400
Entity
Organization
Contact information
Practice address
4425 TAYLOR AVE, RACINE, WI 53405-4642
(262) 554-1400
Mailing address
4425 TAYLOR AVE, RACINE, WI 53405-4642
(262) 554-1400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1575
WI
101YM0800X
Mental Health Counselor
Primary
1575
WI
101YP2500X
Professional Counselor
1575
WI
Other
Enumeration date
07/17/2007
Last updated
07/26/2007
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