Provider Demographics
NPI:1477623643
Name:PSYCHOLOGICAL & COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL & COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ADAMCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-571-9484
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-0294
Mailing Address - Country:US
Mailing Address - Phone:414-571-9484
Mailing Address - Fax:414-571-9648
Practice Address - Street 1:6929 MARINER DR UNIT D
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-3938
Practice Address - Country:US
Practice Address - Phone:414-571-9484
Practice Address - Fax:414-571-9648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty