Individual
LEVI M PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2677 N 40TH ST, MILWAUKEE, WI 53210
(414) 447-1965
(414) 447-1964
Mailing address
2677 N 40TH ST, MILWAUKEE, WI 53210-2505
(414) 447-1965
(414) 447-1964
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15853-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029517
—
WI
Enumeration date
01/06/2012
Last updated
07/25/2019
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