Organization
INTEGRATED LIFE COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HADWAT SANKARI LCSW (SOCIAL WORKER, LCSW)
(262) 416-2922
Entity
Organization
Contact information
Practice address
215 N MAIN ST, 205, WEST BEND, WI 53095-3347
(262) 416-2922
Mailing address
265 TERRACE DR, WEST BEND, WI 53095-4748
(262) 416-2922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7824-123
WI
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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