Provider Demographics
NPI:1114059326
Name:THUECKS, KAY (SW)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:THUECKS
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E WASHINGTON ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2585
Mailing Address - Country:US
Mailing Address - Phone:262-335-4545
Mailing Address - Fax:262-335-6827
Practice Address - Street 1:333 E WASHINGTON ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2585
Practice Address - Country:US
Practice Address - Phone:262-335-4545
Practice Address - Fax:262-335-6827
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker