Organization
CHRISTIAN LIFE COUNSELING LLC
Active
Other names
Christian Life Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MENGO (ADMINISTRATOR)
(262) 785-1008
Entity
Organization
Contact information
Practice address
12630 W NORTH AVE BLDG E, BROOKFIELD, WI 53005-4626
(262) 785-1008
(262) 462-3187
Mailing address
12630 W NORTH AVE BLDG E, BROOKFIELD, WI 53005-4626
(262) 785-1008
(262) 462-3187
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/04/2006
Last updated
04/26/2018
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