Organization
19PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY REE MCCOLLUM LCSW (OWNER/DIRECTOR)
(414) 630-4986
Entity
Organization
Contact information
Practice address
4039 N 19TH PL, MILWAUKEE, WI 53209-6806
(414) 630-4986
Mailing address
4039 N 19TH PL, MILWAUKEE, WI 53209-6806
(414) 630-4986
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
8345-123
WI
Other
Enumeration date
08/17/2017
Last updated
07/21/2022
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