| Holifield Counseling And Consulting | |
|
6944 N Port Washington Rd Glendale WI 53217-3923 | |
| (414) 702-6130 | |
| Not Available |
| Full Name | Holifield Counseling And Consulting |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6944 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | James Walter Holifield (OWNER) |
| Authorized Official Contact | 4147026130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holifield Counseling And Consulting 6944 N Port Washington Rd Glendale WI 53217-3923 Ph: (414) 702-6130 | Holifield Counseling And Consulting 6944 N Port Washington Rd Glendale WI 53217-3923 Ph: (414) 702-6130 |
| NPI Number | 1730224130 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730224130 | NPI | - | NPPES |
| 39293200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 3086-123 (Wisconsin) | Primary |
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