Provider Demographics
NPI:1003867813
Name:ALLIED COUNSELING SERVICES, S.C.
Entity type:Organization
Organization Name:ALLIED COUNSELING SERVICES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:C
Authorized Official - Last Name:FREIBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-751-5672
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-0212
Mailing Address - Country:US
Mailing Address - Phone:262-751-5672
Mailing Address - Fax:855-702-2180
Practice Address - Street 1:2717 N GRANDVIEW BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1660
Practice Address - Country:US
Practice Address - Phone:262-751-5672
Practice Address - Fax:855-702-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1950103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42193600Medicaid