Organization
INNER CITY BEHAVIOR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA TRIPP LPC (CEO)
(414) 249-3571
Entity
Organization
Contact information
Practice address
4738 W LISBON AVE, MILWAUKEE, WI 53208-2416
(414) 249-3571
(414) 249-3876
Mailing address
4738 W LISBON AVE STE 8, MILWAUKEE, WI 53208-1127
(414) 249-3571
(414) 249-3876
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5949-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669642591
—
WI
Enumeration date
03/11/2016
Last updated
03/11/2016
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