| Professional Services Group, Inc. | |
|
2323 N 25th St Milwaukee WI 53206-1003 | |
| (414) 344-3061 | |
| (414) 344-1060 |
| Full Name | Professional Services Group, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2323 N 25th St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Brian A. Wolf (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2626522406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Services Group, Inc. 6233 39th Ave Kenosha WI 53142-7015 Ph: (262) 654-1004 | Professional Services Group, Inc. 2323 N 25th St Milwaukee WI 53206-1003 Ph: (414) 344-3061 |
| NPI Number | 1568548170 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568548170 | NPI | - | NPPES |
| 42235000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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