Healthcare Provider Details

I. General information

NPI: 1265255368
Provider Name (Legal Business Name): KIRKPATRICK & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N 6TH ST
REEDSVILLE WI
54230-9304
US

IV. Provider business mailing address

PO BOX 218
REEDSVILLE WI
54230-0218
US

V. Phone/Fax

Practice location:
  • Phone: 920-840-2745
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARSHALL KIRKPATRICK
Title or Position: CEO
Credential:
Phone: 920-840-2745