Organization
HOLIFIELD COUNSELING AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES WALTER HOLIFIELD LCSW (OWNER)
(414) 702-6130
Entity
Organization
Contact information
Practice address
6944 N PORT WASHINGTON RD, GLENDALE, WI 53217-3923
(414) 702-6130
Mailing address
6944 N PORT WASHINGTON RD, GLENDALE, WI 53217-3923
(414) 702-6130
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3086-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39293200
—
WI
Enumeration date
02/21/2007
Last updated
08/09/2012
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