Healthcare Provider Details

I. General information

NPI: 1447164017
Provider Name (Legal Business Name): KATELYN KRAHN APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 N SUPERIOR AVE STE A1
TOMAH WI
54660-1107
US

IV. Provider business mailing address

505 LARKIN ST APT 306
TOMAH WI
54660-1795
US

V. Phone/Fax

Practice location:
  • Phone: 608-501-1189
  • Fax:
Mailing address:
  • Phone: 608-501-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number136133-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: