Healthcare Provider Details

I. General information

NPI: 1982508461
Provider Name (Legal Business Name): NATHAN MICHAEL ROWINSKY LPC-IT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 N OAKLAND AVE
GREEN BAY WI
54303-2831
US

IV. Provider business mailing address

1415 HASTINGS ST
ALLOUEZ WI
54301-2427
US

V. Phone/Fax

Practice location:
  • Phone: 920-770-4088
  • Fax:
Mailing address:
  • Phone: 920-540-5402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9357-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: