Organization
LIVING FOR LIBERATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON BERNICE WESTPHAL MSW, LCSW (PSYCHOTHERAPIST)
(262) 226-0391
Entity
Organization
Contact information
Practice address
111 WARREN ST STE 2, BEAVER DAM, WI 53916-3084
(262) 226-0391
Mailing address
PO BOX 131, HUSTISFORD, WI 53034-0131
(262) 224-7721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
05/12/2023
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