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NPI Code Detail

MEDICARE: LAURA L MENNINGEN CSAC

MEDICARE: LAURA L MENNINGEN CSAC
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 Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor3411WI

General Provider Information

NPI Number : 1609844083
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA L MENNINGEN CSAC
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1102 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1708
Country : US
Telephone Number : 608-282-8270
Fax Number : 608-278-8204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 03/28/2024

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Directions to “ LAURA L MENNINGEN CSAC” Practice Location

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