Provider Demographics
NPI:1538495775
Name:LIFE FOCUS COUNSELING SC
Entity type:Organization
Organization Name:LIFE FOCUS COUNSELING SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW ACSW CSAC
Authorized Official - Phone:262-989-6212
Mailing Address - Street 1:6214 WASHINGTON AVE
Mailing Address - Street 2:SUITE C-10
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-3986
Mailing Address - Country:US
Mailing Address - Phone:262-989-6212
Mailing Address - Fax:262-884-4405
Practice Address - Street 1:6214 WASHINGTON AVE
Practice Address - Street 2:SUITE C-10
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-3986
Practice Address - Country:US
Practice Address - Phone:262-989-6212
Practice Address - Fax:262-884-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6718-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty