Provider Demographics
NPI:1033877634
Name:TRINKNER, KELSEY EILEEN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:EILEEN
Last Name:TRINKNER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 US HIGHWAY 12 E STE 225
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-3045
Mailing Address - Country:US
Mailing Address - Phone:715-232-1116
Mailing Address - Fax:715-232-5987
Practice Address - Street 1:3001 US HIGHWAY 12 E STE 160
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-3045
Practice Address - Country:US
Practice Address - Phone:715-232-1116
Practice Address - Fax:715-232-5987
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10679-15101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100196373Medicaid
15535286OtherCAQH