Provider Demographics
NPI:1528413671
Name:ADVENTURES IN PLAY, LLC
Entity Type:Organization
Organization Name:ADVENTURES IN PLAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCSW
Authorized Official - Phone:847-722-6704
Mailing Address - Street 1:2118 E KENILWORTH PL
Mailing Address - Street 2:LOWR
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1327
Mailing Address - Country:US
Mailing Address - Phone:847-722-6704
Mailing Address - Fax:414-306-7171
Practice Address - Street 1:2118 E KENILWORTH PL
Practice Address - Street 2:LOWR
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1327
Practice Address - Country:US
Practice Address - Phone:847-722-6704
Practice Address - Fax:414-306-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8463-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health