Provider Demographics
NPI:1114517604
Name:LAMPE, TONI L (LPC)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:L
Last Name:LAMPE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:L
Other - Last Name:LAMPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1215 CARMEN AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-7614
Mailing Address - Country:US
Mailing Address - Phone:920-917-8044
Mailing Address - Fax:
Practice Address - Street 1:621 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN FALLS
Practice Address - State:WI
Practice Address - Zip Code:53085-1544
Practice Address - Country:US
Practice Address - Phone:920-305-6313
Practice Address - Fax:920-306-8027
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4817-226101YP2500X
WI10283-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty