Healthcare Provider Details

I. General information

NPI: 1356208425
Provider Name (Legal Business Name): CAMRYN SHELLEY CHRISTOPHERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 S CHERRY AVE STE 4
MARSHFIELD WI
54449-4276
US

IV. Provider business mailing address

N49175 TRACEY VALLEY RD
OSSEO WI
54758-8757
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-2729
  • Fax:
Mailing address:
  • Phone: 715-533-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8832-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: