Provider Demographics
NPI:1063837896
Name:WINSTON, NANCY (LPC-IT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:WINSTON
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3849
Mailing Address - Country:US
Mailing Address - Phone:414-817-8896
Mailing Address - Fax:414-817-8940
Practice Address - Street 1:15285 WATERTOWN PLANK RD
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2339
Practice Address - Country:US
Practice Address - Phone:262-797-2818
Practice Address - Fax:262-797-2814
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1632-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional