Organization Active NPI

Child and Adult Psychotherapy Clinic, LLC

  • Social Worker
  • Milwaukee, WI
National Provider Identifier
1093124083
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3394123 Issued in WI
Legal business name
CHILD AND ADULT PSYCHOTHERAPY CLINIC, LLC
Practice address
230 W Wells St
Milwaukee, WI 53203-1866
Phone
(414) 380-3327
Fax
(414) 276-6819
NPI assigned
Aug 4, 2014
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Janice E. Lieber, M.A.
Title
Owner/Psychotherapist
Phone
(414) 380-3327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 3394123 WI Primary

Addresses

Primary practice location

230 W Wells St
Milwaukee, WI 53203-1866

Mailing address

230 W Wells St
Milwaukee, WI 53203-1866
Phone (414) 380-3327

Other identifiers 1

IdentifierTypeStateIssuer
1871602870MedicaidWI

National Provider Directory

National Provider Directory

Locations

230 W Wells St
Milwaukee, WI 53203
Phone (414) 324-4999

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1093124083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031866",
            "telephone_number": "414-380-3327",
            "fax_number": "414-276-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031866",
            "telephone_number": "414-380-3327",
            "fax_number": "414-276-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND ADULT PSYCHOTHERAPY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "LIEBER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-380-3327",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "WI",
            "license": "3394123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871602870",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.