Provider Demographics
NPI:1164639910
Name:BAVLNKA, CLAUDIA MUIR (LPC)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:MUIR
Last Name:BAVLNKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1762
Mailing Address - Country:US
Mailing Address - Phone:608-355-4103
Mailing Address - Fax:608-355-4106
Practice Address - Street 1:449 HITCHCOCK ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2876
Practice Address - Country:US
Practice Address - Phone:608-355-4103
Practice Address - Fax:608-355-4106
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3792-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43708500Medicaid