Healthcare Provider Details

I. General information

NPI: 1932795499
Provider Name (Legal Business Name): PAHOUA XIONG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11649 N PORT WASHINGTON RD STE 221
MEQUON WI
53092-3461
US

IV. Provider business mailing address

PO BOX 148
BUTLER WI
53007-0148
US

V. Phone/Fax

Practice location:
  • Phone: 262-912-1922
  • Fax: 262-478-0030
Mailing address:
  • Phone: 141-247-0801
  • Fax: 141-247-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11212-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: