Organization
M D THERAPY LLC
Active
Other names
Directors of Continuation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MICHAEL DALE LPC (PRESIDENT)
(414) 264-6155
Entity
Organization
Contact information
Practice address
3118 N TEUTONIA AVE, MILWAUKEE, WI 53206-2264
(414) 264-6155
(414) 264-8288
Mailing address
3118 N TEUTONIA AVE, MILWAUKEE, WI 53206-2264
(414) 264-6155
(414) 264-8288
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2225
WI
106H00000X
Marriage & Family Therapist
Primary
2225
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HFS 61.91
MENTAL HEALTH-OUTPATIENT
WI
01
—
HFS 75.13
CSAS-OUTPATIENT TREATMENT
WI
Enumeration date
06/26/2007
Last updated
09/11/2025
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