Provider Demographics
NPI:1053634089
Name:PACZESNY, ANNE CATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CATHERINE
Last Name:PACZESNY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:890 ELM GROVE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2528
Mailing Address - Country:US
Mailing Address - Phone:414-403-0524
Mailing Address - Fax:262-285-3286
Practice Address - Street 1:890 ELM GROVE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2528
Practice Address - Country:US
Practice Address - Phone:414-403-0524
Practice Address - Fax:262-285-3286
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2014-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical