Provider Demographics
NPI:1548960800
Name:STANDARD OF CARE COUNSELING AND CONSULTATION SERVICE LLC
Entity type:Organization
Organization Name:STANDARD OF CARE COUNSELING AND CONSULTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LEFLORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-899-0111
Mailing Address - Street 1:4465 N OAKLAND AVE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1662
Mailing Address - Country:US
Mailing Address - Phone:414-899-0111
Mailing Address - Fax:
Practice Address - Street 1:4465 N OAKLAND AVE UNIT 110
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:414-899-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)