Provider Demographics
NPI:1083159313
Name:GOCHANOUR-GREINER, KATHERINE S (CSAC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:S
Last Name:GOCHANOUR-GREINER
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1935
Mailing Address - Country:US
Mailing Address - Phone:262-767-0441
Mailing Address - Fax:262-767-9072
Practice Address - Street 1:201 N PINE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1935
Practice Address - Country:US
Practice Address - Phone:262-767-0441
Practice Address - Fax:262-767-9072
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1378-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)