Individual
MR. ELISHA A BARREN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
2555 N MLK DR, MILWAUKEE, WI 53212-2709
(414) 372-8080
(414) 267-8570
Mailing address
2725 W HIGHLAND BLVD, APT 212, MILWAUKEE, WI 53208-4331
(414) 839-0088
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16713-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366998403
—
WI
Enumeration date
08/29/2016
Last updated
12/19/2019
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