Ebb Tide Therapy
Ebb Tide Therapy is an Addiction (Substance Use Disorder) Counselor in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2012.
- Licensed in
- WI
- In the registry since
- 2012
- Specialties on file
- 2
Practice location Address checks out
2821 N 4th St Ste 209Milwaukee, WI 53212-2367
Phone: (414) 372-7212
Fax: (414) 372-7213
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence 7197-123 (WI) |
|---|---|
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence 1971-132 |
Record details
| NPI number | 1720353741 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shannon O'Brien — Therapist · (414) 372-7212 |
| NPI enumerated | March 9, 2012 |
| Last updated in NPPES | July 5, 2012 |
| Mailing address | 2821 N 4th St Ste 209, Milwaukee, WI 53212-2367 |
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