Provider Demographics
NPI:1053882373
Name:ZENA COUNSELING CENTER OF MILWAUKEE LLC
Entity type:Organization
Organization Name:ZENA COUNSELING CENTER OF MILWAUKEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZIZA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DAHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:414-247-9005
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092-0639
Mailing Address - Country:US
Mailing Address - Phone:414-247-9005
Mailing Address - Fax:414-247-9004
Practice Address - Street 1:3927 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-4421
Practice Address - Country:US
Practice Address - Phone:844-458-4201
Practice Address - Fax:414-247-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-14
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6820OtherSTATE LICENSE
WI100060823Medicaid