Provider Demographics
NPI:1487054060
Name:WINTERS, ESPERANZA (LPC)
Entity type:Individual
Prefix:MS
First Name:ESPERANZA
Middle Name:
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 N HARTUNG AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1340
Mailing Address - Country:US
Mailing Address - Phone:414-236-1065
Mailing Address - Fax:414-238-9511
Practice Address - Street 1:4465 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1662
Practice Address - Country:US
Practice Address - Phone:414-563-7229
Practice Address - Fax:262-364-2189
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100070737Medicaid