Provider Demographics
NPI:1043529381
Name:MEISNER, DEBORAH ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:MEISNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-0533
Mailing Address - Country:US
Mailing Address - Phone:262-444-9977
Mailing Address - Fax:866-280-9793
Practice Address - Street 1:2100 CHURCH ST STE 104
Practice Address - Street 2:
Practice Address - City:EAST TROY
Practice Address - State:WI
Practice Address - Zip Code:53120-1304
Practice Address - Country:US
Practice Address - Phone:262-444-9977
Practice Address - Fax:866-280-9793
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MOL2016008565101YP2500X
WI8211125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor