Provider Demographics
NPI:1629409164
Name:CJS SOLUTION TO DEPRESSION & ANXIETY
Entity Type:Organization
Organization Name:CJS SOLUTION TO DEPRESSION & ANXIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO THERAPIST/CONTRACTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-573-2579
Mailing Address - Street 1:9220 N 75TH ST
Mailing Address - Street 2:APT 222
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-1143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9220 N 75TH ST
Practice Address - Street 2:APT 222
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-1143
Practice Address - Country:US
Practice Address - Phone:414-573-2579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health