Provider Demographics
NPI:1598090235
Name:WOODS, PHILLIP NOBLE (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:NOBLE
Last Name:WOODS
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6555 N 113TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-5048
Mailing Address - Country:US
Mailing Address - Phone:414-708-1523
Mailing Address - Fax:414-988-6771
Practice Address - Street 1:11414 W PARK PL STE 248
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-3500
Practice Address - Country:US
Practice Address - Phone:414-708-1523
Practice Address - Fax:414-988-6771
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4148-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional