Provider Demographics
NPI:1265673412
Name:EW COUNSELING, INC.
Entity Type:Organization
Organization Name:EW COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC, ICS
Authorized Official - Phone:262-412-0670
Mailing Address - Street 1:5407 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-3715
Mailing Address - Country:US
Mailing Address - Phone:262-412-0670
Mailing Address - Fax:
Practice Address - Street 1:5407 8TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3715
Practice Address - Country:US
Practice Address - Phone:262-412-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2106-132101YA0400X
WI11581-134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1609076322OtherINDIVIDUAL
WI1083813224OtherGROUP