Healthcare Provider Details

I. General information

NPI: 1588103824
Provider Name (Legal Business Name): KATHERINE GEISER LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE GUSTAFSON

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6592 LAKE RD STE B11
WINDSOR WI
53598-9811
US

IV. Provider business mailing address

6592 LAKE RD STE B11
WINDSOR WI
53598-9811
US

V. Phone/Fax

Practice location:
  • Phone: 608-480-8013
  • Fax:
Mailing address:
  • Phone: 608-480-8013
  • Fax: 608-480-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number7116
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: