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NPI Code Detail

MEDICARE: KATHRYN STOCKS LPC, SAC-IT, NCC

MEDICARE:   KATHRYN  STOCKS  LPC, SAC-IT, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor11206-125WI

General Provider Information

NPI Number : 1154143295
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN STOCKS LPC, SAC-IT, NCC
Provider Business Mailing Address
First Line : 4350 W DEER RUN DR APT 101
Second Line :
City : BROWN DEER
State : WI
Zip : 53223-6410
Country : US
Telephone Number : 414-559-0054
Fax Number :
Provider Business Practice Location Address
First Line : 4530 N OAKLAND AVE
Second Line :
City : WHITEFISH BAY
State : WI
Zip : 53211-1215
Country : US
Telephone Number : 414-559-0054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2024
Last Update Date : 10/29/2024

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Directions to “ KATHRYN STOCKS LPC, SAC-IT, NCC” Practice Location

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