Provider Demographics
NPI:1124233358
Name:KOLASINSKI, VICKY (MSE, LPC)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:KOLASINSKI
Suffix:
Gender:F
Credentials:MSE, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-9372
Mailing Address - Country:US
Mailing Address - Phone:715-252-1451
Mailing Address - Fax:
Practice Address - Street 1:5541 HWY 10 EAST
Practice Address - Street 2:SUITE B
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481
Practice Address - Country:US
Practice Address - Phone:715-345-9690
Practice Address - Fax:715-345-2938
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI928-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional