Eastlake Counseling and Consulting II

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EASTLAKE COUNSELING AND CONSULTING II

Practice address

135 W Wells St
Suite 226
Milwaukee, WI 53203-1830

Phone

(414) 272-0123

Fax

(414) 272-3498

NPI assigned

May 6, 2008

Last updated

May 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Beth Shaffer, LCSWNPI 1306971031

Title

Co Director

Phone

(414) 272-0123

Specialties & licenses 1

Addresses

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.

• Mary Beth Shaffer

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1306971031
  Authorized official Same address or phone

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1629244983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W WELLS ST",
            "address_2": "SUITE 226",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031830",
            "telephone_number": "414-272-0123",
            "fax_number": "414-272-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W WELLS ST",
            "address_2": "SUITE 226",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031830",
            "telephone_number": "414-272-0123",
            "fax_number": "414-272-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAKE COUNSELING AND CONSULTING II",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CO DIRECTOR",
        "authorized_official_telephone_number": "414-272-0123",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastcastle Place, Inc. (Eastcastle Place Bradford Terrace Convalescent Center)
• Easter Seals Southeast Wisconsin
• Michaela Brannan Easter
• Jordan Taylor Easterlin
• Eastlake Counseling
• Aaron R Eastman, APNP
• Eastside Critical Care LLC
• Eastside Dental LLC
• Eastside Operating Company LLC (Lake Terrace Health and Rehabilitation)
• Easy Does It Transportation

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.