Provider Demographics
NPI:1053643403
Name:STRAND-GLATCZAK, MELANIE (CSAC LPC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:STRAND-GLATCZAK
Suffix:
Gender:F
Credentials:CSAC LPC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:STRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC
Mailing Address - Street 1:1493 COUNTY RD Q
Mailing Address - Street 2:
Mailing Address - City:HATLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:630 S 36TH AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3930
Practice Address - Country:US
Practice Address - Phone:715-842-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7723101YP2500X
WI15420-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional