Healthcare Provider Details

I. General information

NPI: 1609927011
Provider Name (Legal Business Name): TUNGSETH PSYCHOTHERAPY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6233 DURAND AVE SUITE F
RACINE WI
53406-4961
US

IV. Provider business mailing address

6233 DURAND AVE SUITE F
RACINE WI
53406-4961
US

V. Phone/Fax

Practice location:
  • Phone: 262-554-8165
  • Fax: 262-554-8152
Mailing address:
  • Phone: 262-554-8165
  • Fax: 262-554-8152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARGARET J TUNGSETH
Title or Position: DIRECTOR
Credential: LCSW
Phone: 262-554-8165