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NPI Code Detail

MEDICARE: MRS. KAYLA M OSTERMANN LPC

MEDICARE: MRS. KAYLA M OSTERMANN 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
1101YP2500XProfessional Counselor5430-125WI
2101YP2500XProfessional Counselor921-226WI
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)5430WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538413752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAYLA M OSTERMANN LPC
Provider Business Mailing Address
First Line : 3900 W BROWN DEER RD
Second Line : STE 200
City : BROWN DEER
State : WI
Zip : 53209-1220
Country : US
Telephone Number : 414-540-2170
Fax Number : 414-540-2171
Provider Business Practice Location Address
First Line : 1721 SAEMANN AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-2342
Country : US
Telephone Number : 920-783-6633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2012
Last Update Date : 12/11/2019

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