Individual
LISA ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
790 N MILWAUKEE ST, MILWAUKEE, WI 53202-3724
(262) 706-5868
(414) 485-6843
Mailing address
790 N MILWAUKEE ST, MILWAUKEE, WI 53202-3724
(262) 706-5868
(414) 485-6843
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15821-132
WI
101YP2500X
Professional Counselor
Primary
1621-226
WI
Other
Enumeration date
12/05/2013
Last updated
02/12/2026
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