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General NPI Number Information
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NPI Number | 1386521474
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Entity Type | Individual
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Provider Name | AUTUMN R DEPAOLI LPC-IT
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 4240 N MAIN ST APT 304
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City | RACINE
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State | WI
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Zip | 53402-2884
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Country | US
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Telephone | 906-290-4590
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Fax |
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Provider Business Mailing Address
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Address Line | 4240 N MAIN ST APT 304
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City | RACINE
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State | WI
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Zip | 53402-2884
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Country | US
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Telephone | 906-290-4590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 7970-226
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License Number State | WI
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