Organization
INTERCONNECTIONS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH NICHOLS LCSW (CO-DIRECTOR)
(262) 654-5333
Entity
Organization
Contact information
Practice address
920 60TH ST, KENOSHA, WI 53140-4041
(262) 654-5333
(262) 654-7818
Mailing address
920 60TH ST, KENOSHA, WI 53140-4041
(262) 654-5333
(262) 654-7818
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1440
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42133400
—
WI
Enumeration date
11/22/2006
Last updated
11/08/2019
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