Healthcare Provider Details

I. General information

NPI: 1780391987
Provider Name (Legal Business Name): TAYLOR KRUEGER LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MILL ST STE 104
MERRILL WI
54452-2558
US

IV. Provider business mailing address

100 S MILL ST STE 104
MERRILL WI
54452-2558
US

V. Phone/Fax

Practice location:
  • Phone: 855-607-8242
  • Fax: 715-848-0425
Mailing address:
  • Phone: 855-607-8242
  • Fax: 715-848-0425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: