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NPI Code Detail

MEDICARE: KATIE A WERREN LPC, SAC-IT

MEDICARE: KATIE A WERREN LPC, SAC-IT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor18293-130WI
2101YM0800XMental Health Counselor6625-125WI
3101YP2500XProfessional Counselor6625-125WI

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 : 1538706833
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE A WERREN LPC, SAC-IT
Provider Business Mailing Address
First Line : 200 S HICKORY ST
Second Line :
City : MAUSTON
State : WI
Zip : 53948-1320
Country : US
Telephone Number : 608-847-2400
Fax Number : 608-847-9599
Provider Business Practice Location Address
First Line : 200 S HICKORY ST
Second Line :
City : MAUSTON
State : WI
Zip : 53948-1320
Country : US
Telephone Number : 608-847-2400
Fax Number : 608-847-9599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2019
Last Update Date : 11/29/2021

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