LIFE ENHANCED COUNSELING SERVICES (NPI# 1205473329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205473329 |
| Entity Type | Organization |
| Organization Name | LIFE ENHANCED COUNSELING SERVICES |
| Practice Address |
5330 W Villard Ave Milwaukee WI 53218-4345 |
| Mailing Address |
1711 W Clayton Crest Ave Milwaukee WI 53221-3830 |
| Practice Telephone | 4146900672 |
| Mailing Telephone | 4146900672 |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | TONYETTA L ROSS (DIRECTOR) |
| Authorized Official Telephone | 4146900672 |
| Authorized Official Credential | LPC, CSAC, ICAAD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10200 N Port Washington Rd, Mequon, WI 530925765 | 4146900672 |
| Street Address |
5330 W VILLARD AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53218-4345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497799860 | Villard Primary & Specialty Care S.c. | Family Medicine | 5330 W Villard Ave, Milwaukee, WI 53218-4345 | 2006-06-16 |
| 1750692364 | Rachel Busalacchi | Physician Assistant | 5330 W Villard Ave, Milwaukee, WI 53218-4345 | 2010-06-29 |
| 1003132473 | Tonyetta L Ross | Counselor | 5330 W Villard Ave, Milwaukee, WI 53218-4345 | 2010-04-10 |
| 1578794897 | Michael James Nielsen | Physician Assistant | 5330 W Villard Ave, Milwaukee, WI 53218-4345 | 2009-08-04 |
| 1942236088 | Catherine Smet | Nurse Practitioner | 5330 W Villard Ave, Milwaukee, WI 53218-4345 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417571050 | Kaak Living | Clinic/Center | 5938 N 76th Street, Milwaukee, WI 53218 | 2020-05-29 |
| 1306495064 | Jeanette Bearden | Technician | 4477 N 57 St., Milwaukee, WI 53218 | 2019-09-05 |
| 1770074080 | Sunvale Homes LLC | Home Health | 4714 N 58th St, Milwaukee, WI 53218 | 2018-05-22 |
| 1447740006 | Quantum Care LLC | Home Health | 6424 W Fondulac Avenue, Unit 1, Milwaukee, WI 53218 | 2018-05-18 |
| 1811413008 | Ewura Asie Amonoo | Case Manager/Care Coordinator | 5153 W. Silver Spring, Milwaukee, WI 53218 | 2017-08-18 |
| 1649706714 | Life Tree Pharmacy LLC | Pharmacy | 8329-5 W Appleton Ave, Milwaukee, WI 53218 | 2017-05-10 |
| 1720524341 | Nastassia S Jackson | Counselor | 6830 W Villard Ave Ste 190, Milwaukee, WI 53218 | 2017-01-07 |
| 1801330493 | Mary Beth Cafaro | Social Worker | 5555 N. 51st Blvd, Milwaukee, WI 53218 | 2016-12-15 |
| 1669823613 | Lasonya Carol Wilson | Licensed Practical Nurse | 5830 N 75th St, Milwaukee, WI 53218 | 2016-06-30 |
| 1225302243 | Drew Douglas Cannon | Social Worker | 5555 N 51st Street, Milwaukee, WI 53218 | 2012-03-08 |
| Find all providers in zip 53218 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316587439 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 1635 W National Ave, Milwaukee, WI 53204-1130 | 2020-01-07 |
| 1689149700 | Birt Supportive Services LLC | Clinic/Center | 4868 N 89th St, Milwaukee, WI 53225-4106 | 2018-10-04 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1679981328 | Life Changing Ministries Substance Abuse Services | Clinic/Center | 1134 W North Ave 2nd Floor, Milwaukee, WI 53205 | 2014-07-25 |
| 1962839589 | Shoreview Counseling Services | Clinic/Center | 4950 N 21st St, Lower Level, Milwaukee, WI 53209-5750 | 2013-09-27 |
| 1952608721 | Community Advocates, Inc | Clinic/Center | 4906 W Fond Du Lac Ave, Milwaukee, WI 53216-2325 | 2011-02-14 |
| 1841438769 | Counseling & Transition Center Inc | Clinic/Center | 3073 S. Chase Ave, Suite 326, Milwaukee, WI 53207 | 2009-01-30 |
| 1639193212 | Horizon Healthcare, Inc | Clinic/Center | 5408 W Burleigh St, Milwaukee, WI 53210-1624 | 2006-07-27 |
| 1053934034 | Heather Hart Kennedy, Lcsw, LLC | Clinic/Center | 1110 N Old World 3rd St Ste 401, Milwaukee, WI 53203-1117 | 2020-05-25 |
| 1033772058 | Different Shades of Healing, LLC | Clinic/Center | 6830 W Villard Ave Ste 190, Milwaukee, WI 53218-3968 | 2019-04-16 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.