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General NPI Number Information
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NPI Number | 1861087439
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Entity Type | Individual
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Provider Name | KRISTINA L SEGLAH CADC-II, CSAC, CSI-T
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 412 S ANDREWS ST 1/2
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City | SHAWANO
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State | WI
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Zip | 54166-2902
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Country | US
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Telephone | 971-770-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 412 S. ANDREWS ST. 1/2
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City | SHAWANO
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State | WI
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Zip | 54166
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Country | US
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Telephone | 971-400-8150
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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 | 17191-133
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17255-132
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 22-QMHA-I-003390
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 23-08-20313
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License Number State | OR
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