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General NPI Number Information
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NPI Number | 1669384418
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Entity Type | Individual
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Provider Name | LARRY WESLEY KAHL
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Gender | Male
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 2702 INTERNATIONAL LN
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City | MADISON
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State | WI
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Zip | 53704-3117
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Country | US
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Telephone | 608-205-8798
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Fax |
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Provider Business Mailing Address
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Address Line | 1473 AMENDMENT DR
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City | NEENAH
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State | WI
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Zip | 54956-9677
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Country | US
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Telephone | 360-515-8700
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1265-132
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1295-125
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License Number State | WI
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