Provider Demographics
NPI:1467699272
Name:ADKINS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ADKINS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:SYVILLE
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, SAC-IT
Authorized Official - Phone:414-573-0707
Mailing Address - Street 1:6001 W CENTER ST
Mailing Address - Street 2:SUTIE 208
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2154
Mailing Address - Country:US
Mailing Address - Phone:414-393-1099
Mailing Address - Fax:414-393-9773
Practice Address - Street 1:6001 W CENTER ST
Practice Address - Street 2:SUTIE 208
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2154
Practice Address - Country:US
Practice Address - Phone:414-393-1099
Practice Address - Fax:414-393-9773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14841-130251S00000X
WI4059 125251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43725300Medicaid