Organization
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY OERTER (INTERIM DIRECTOR OF COUNSELING)
(414) 266-2912
Entity
Organization
Contact information
Practice address
620 S 76TH ST, SUITE 120, MILWAUKEE, WI 53214-1549
(414) 453-1400
(414) 453-2538
Mailing address
620 S 76TH ST, SUITE 120, MILWAUKEE, WI 53214-1549
(414) 453-1400
(414) 453-2538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42155200
—
WI
Enumeration date
04/17/2008
Last updated
12/05/2013
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