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Individual

MS. CHARLENE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
5501 W BURLEIGH ST, MILWAUKEE, WI 53210
(414) 828-5617
(414) 643-1018
Mailing address
5501 W BURLEIGH ST, MILWAUKEE, WI 53210-1548
(414) 828-5617
(414) 643-1018

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16837-130
WI
101YP2500X
Professional Counselor
2697-226
WI

Other

Enumeration date
07/15/2016
Last updated
05/31/2018
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