Healthcare Provider Details

I. General information

NPI: 1295182871
Provider Name (Legal Business Name): KARRIE HARMON APSW, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARRIE WILSON APSW, CSAC

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 GERSHWIN DR
GREEN BAY WI
54311-4328
US

IV. Provider business mailing address

3150 GERSHWIN DR
GREEN BAY WI
54311-4328
US

V. Phone/Fax

Practice location:
  • Phone: 920-391-6962
  • Fax: 920-391-4731
Mailing address:
  • Phone: 920-391-6962
  • Fax: 920-391-4731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number135661
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16376
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: