Provider Demographics
NPI:1679243471
Name:MSM COUNSELING SVC.LTD.CO
Entity Type:Organization
Organization Name:MSM COUNSELING SVC.LTD.CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOEKETSI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLAOLI
Authorized Official - Suffix:III
Authorized Official - Credentials:LPC
Authorized Official - Phone:414-649-1667
Mailing Address - Street 1:6400 INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2452
Mailing Address - Country:US
Mailing Address - Phone:141-485-8410
Mailing Address - Fax:414-423-4134
Practice Address - Street 1:305 E BUSINESS HIGHWAY 151 STE D
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-3767
Practice Address - Country:US
Practice Address - Phone:414-649-1667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty