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General NPI Number Information
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NPI Number | 1922657345
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Entity Type | Individual
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Provider Name | CARMEN LETARSKI LPC
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 530 GRANT ST
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City | WAUSAU
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State | WI
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Zip | 54403-4738
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Country | US
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Telephone | 715-432-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N 1ST ST APT 114
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City | WAUSAU
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State | WI
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Zip | 54403-3595
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Country | US
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Telephone | 715-432-6471
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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 | 18555-130
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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 | 8661-125
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License Number State | WI
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