Provider Demographics
NPI:1710608187
Name:PROMISE COUNSELING AND COACHING LLC.
Entity Type:Organization
Organization Name:PROMISE COUNSELING AND COACHING LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIA
Authorized Official - Middle Name:LYZETTA-MARIE
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-IT, SAC-IT
Authorized Official - Phone:414-499-5765
Mailing Address - Street 1:6114 W CAPITOL DR STE 305A
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2147
Mailing Address - Country:US
Mailing Address - Phone:414-499-5765
Mailing Address - Fax:
Practice Address - Street 1:6114 W CAPITOL DR STE 305A
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2147
Practice Address - Country:US
Practice Address - Phone:414-499-5765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)