Healthcare Provider Details

I. General information

NPI: 1801751235
Provider Name (Legal Business Name): KIRSTEN WEBSTER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

2876 MAPLE WOOD CT
FITCHBURG WI
53711-5184
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number129861-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: