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NPI Code Detail

MEDICARE: REGINA E CUELLAR-PROCTOR LPC, CSAC

MEDICARE: REGINA E CUELLAR-PROCTOR LPC, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor13990WI
2101YM0800XMental Health Counselor6823-125WI
3101YA0400XAddiction (Substance Use Disorder) Counselor15632-132WI

General Provider Information

NPI Number : 1659538361
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA E CUELLAR-PROCTOR LPC, CSAC
Provider Business Mailing Address
First Line : 3150 GERSHWIN DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-4328
Country : US
Telephone Number : 920-391-4700
Fax Number : 920-391-4870
Provider Business Practice Location Address
First Line : 3150 GERSHWIN DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-4328
Country : US
Telephone Number : 920-391-4700
Fax Number : 920-391-4870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 03/14/2018

Similar Medicare Providers

1083569370 — ASHLEY N ZELLNER
Practice Location Address:
3150 GERSHWIN DR
GREEN BAY, WI
54311-4328
Practice Phone: 920-391-4751
Practice Fax:
1093930067 — YOGESH C PAREEK M.D.
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1457541716 — LISA M. KRUEGER LPC, CRC
Practice Location Address:
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54311-4328
Practice Phone: 920-391-4740
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1558650705 — MRS. KRISTIN A. ANDERSON-CRONIN PMHNP-BC
Practice Location Address:
3150 GERSHWIN DR
GREEN BAY, WI
54311-4328
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Practice Fax:
1770875221 — MR. JIM RYAN FRANSON LPC, CSAC, ICS
Practice Location Address:
3150 GERSHWIN DR
GREEN BAY, WI
54311-4328
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1821361833 — RICK D MICELI-WINK CSAC
Practice Location Address:
3150 GERSHWIN DR
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54311-4328
Practice Phone: 920-448-6219
Practice Fax: 920-391-4870

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