Healthcare Provider Details

I. General information

NPI: 1639063928
Provider Name (Legal Business Name): KIRSTEN GUNNARSON MSW, APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 N MAIN ST STE 230
RICE LAKE WI
54868-1774
US

IV. Provider business mailing address

954 30TH ST
CHETEK WI
54728-8031
US

V. Phone/Fax

Practice location:
  • Phone: 715-246-4840
  • Fax: 715-254-9459
Mailing address:
  • Phone: 608-399-4643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135487-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: