MEDICARE: ALEXANDER KRESS LPC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	17689	WI
2	101YP2500X	Professional Counselor	3027	WI
3	101YM0800X	Mental Health Counselor	7198-125	WI

General Provider Information

NPI Number	:	1427406073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER KRESS LPC

Provider Business Mailing Address
First Line	:	5005 UNIVERSITY AVE STE 100
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-5400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-5400
Country	:	US
Telephone Number	:	253-966-6835
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	11/22/2024

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