Healthcare Provider Details

I. General information

NPI: 1265613095
Provider Name (Legal Business Name): STEVE A SHEFCHIK MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 N OAKLAND AVE
GREEN BAY WI
54303-2831
US

IV. Provider business mailing address

1039 W MASON ST
GREEN BAY WI
54303-1842
US

V. Phone/Fax

Practice location:
  • Phone: 920-770-4088
  • Fax: 651-705-0026
Mailing address:
  • Phone: 920-965-7707
  • Fax: 888-496-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3954-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: