Healthcare Provider Details

I. General information

NPI: 1891336715
Provider Name (Legal Business Name): ANDREW JAMES SRNKA M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 HOLMGREN WAY STE 100
GREEN BAY WI
54304-6303
US

IV. Provider business mailing address

3021 HOLMGREN WAY STE 100
GREEN BAY WI
54304-6303
US

V. Phone/Fax

Practice location:
  • Phone: 920-323-7431
  • Fax:
Mailing address:
  • Phone: 920-323-3158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8362-226
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: