Healthcare Provider Details

I. General information

NPI: 1952217317
Provider Name (Legal Business Name): MICHELLE T. MARSCHEL LMFT-IT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 GREEN BAY RD
PLEASANT PRAIRIE WI
53158-2721
US

IV. Provider business mailing address

6233 39TH AVE
KENOSHA WI
53142-7015
US

V. Phone/Fax

Practice location:
  • Phone: 262-652-2406
  • Fax:
Mailing address:
  • Phone: 262-652-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1218-228
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: