Healthcare Provider Details

I. General information

NPI: 1487015152
Provider Name (Legal Business Name): SHAWNA KRIENITZ LPC, ATR, CEDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAWNA DORIOT

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 N ASSOCIATION DR
APPLETON WI
54914-1479
US

IV. Provider business mailing address

245 N METRO DR
APPLETON WI
54913-8572
US

V. Phone/Fax

Practice location:
  • Phone: 920-364-9078
  • Fax: 920-243-1972
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5873-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: