Provider Demographics
NPI:1073942850
Name:KUSTER, CLIFFORD J (LPC)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:J
Last Name:KUSTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13835 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5028
Mailing Address - Country:US
Mailing Address - Phone:715-456-1741
Mailing Address - Fax:715-720-0132
Practice Address - Street 1:4330 GOLF TER STE 209
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4688
Practice Address - Country:US
Practice Address - Phone:715-491-7370
Practice Address - Fax:715-598-6222
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3241-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional