Provider Demographics
NPI:1891011565
Name:ADVANCED SOLUTIONS COUNSELING & THERAPY INC
Entity Type:Organization
Organization Name:ADVANCED SOLUTIONS COUNSELING & THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:262-342-4357
Mailing Address - Street 1:441 MILWAUKEE AVE
Mailing Address - Street 2:1F
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1230
Mailing Address - Country:US
Mailing Address - Phone:262-342-4357
Mailing Address - Fax:262-554-0124
Practice Address - Street 1:441 MILWAUKEE AVE
Practice Address - Street 2:1F
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1230
Practice Address - Country:US
Practice Address - Phone:262-342-4357
Practice Address - Fax:262-554-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7551-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100007583Medicaid