Healthcare Provider Details

I. General information

NPI: 1164918702
Provider Name (Legal Business Name): OLIVIA MARIE KEMPEMA MS-MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA MARIE GILKEY-MEISEGEIER

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date: 08/10/2026
Reactivation Date: 09/15/2026

III. Provider practice location address

8383 GREENWAY BLVD STE 500
MIDDLETON WI
53562-3529
US

IV. Provider business mailing address

8383 GREENWAY BLVD STE 500
MIDDLETON WI
53562-3529
US

V. Phone/Fax

Practice location:
  • Phone: 608-274-0355
  • Fax:
Mailing address:
  • Phone: 608-274-0355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1251124
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number538228
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: