Healthcare Provider Details

I. General information

NPI: 1609141621
Provider Name (Legal Business Name): TABITHA C GARTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TABITHA C YOWELL

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E KIMBERLY AVE
KIMBERLY WI
54136-1404
US

IV. Provider business mailing address

217 E KIMBERLY AVE
KIMBERLY WI
54136-1404
US

V. Phone/Fax

Practice location:
  • Phone: 920-423-4123
  • Fax:
Mailing address:
  • Phone: 920-423-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5358-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: