Healthcare Provider Details

I. General information

NPI: 1154232437
Provider Name (Legal Business Name): AMIE ALICIA VETSCHER LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W156N8327 PILGRIM RD
MENOMONEE FALLS WI
53051-3776
US

IV. Provider business mailing address

17965 BOLTER LN
BROOKFIELD WI
53045-3402
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-1112
  • Fax:
Mailing address:
  • Phone: 262-251-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9303226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: