Provider Demographics
NPI:1144607169
Name:ACCESS COMMUNITY THERAPIES LLC
Entity Type:Organization
Organization Name:ACCESS COMMUNITY THERAPIES LLC
Other - Org Name:OZAUKEE COMMUNITY THERAPIES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:CADD
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:262-233-1818
Mailing Address - Street 1:1245 CHEYENNE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9323
Mailing Address - Country:US
Mailing Address - Phone:262-233-1818
Mailing Address - Fax:414-421-8681
Practice Address - Street 1:1245 CHEYENNE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9323
Practice Address - Country:US
Practice Address - Phone:262-233-1818
Practice Address - Fax:414-421-8681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty