NPIMap

Organization Active NPI

City Transformation, Limited

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
National Provider Identifier
1508175118
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2918 Issued in WI
Legal business name
CITY TRANSFORMATION, LIMITED
Doing business as
City Transformation Clinic North
Practice address
6815 W Capitol Dr Ste 301
Milwaukee, WI 53216-2056
Phone
(414) 616-9744
Fax
(414) 616-9747
NPI assigned
Sep 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Ms. Theresa Anthony, CLINICAL SUPERVISORNPI 1104111236
Title
Executive Director
Phone
(414) 616-9744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 2918 WI Primary

Addresses

Primary practice location

6815 W Capitol Dr Ste 301
Milwaukee, WI 53216-2056

Mailing address

6815 W Capitol Dr Ste 301
Milwaukee, WI 53216-2056
Phone (414) 616-9744

Other identifiers 1

IdentifierTypeStateIssuer
193400000XMedicaidWI

Other names 1

  • City Transformation Clinic North Doing business as

National Provider Directory

National Provider Directory

Locations

6815 W Capitol Dr
Ste 301
Milwaukee, WI 53216
Phone (414) 393-0090

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1508175118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 W CAPITOL DR STE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162056",
            "telephone_number": "414-616-9744",
            "fax_number": "414-616-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 W CAPITOL DR STE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162056",
            "telephone_number": "414-616-9744",
            "fax_number": "414-616-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY TRANSFORMATION, LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-616-9744",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CLINICAL SUPERVISOR"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193400000X",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Transformation Clinic North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 30, 2010; 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.