Healthcare Provider Details

I. General information

NPI: 1861002057
Provider Name (Legal Business Name): KRISTEN M PASCHKE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N GREEN BAY RD
NEENAH WI
54956-2285
US

IV. Provider business mailing address

215 N GREEN BAY ROAD
NEENAH WI
54956
US

V. Phone/Fax

Practice location:
  • Phone: 920-215-1458
  • Fax:
Mailing address:
  • Phone: 920-215-1458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4643-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: