Provider Demographics
NPI:1164861829
Name:KRUEGER, NANCY AHLGREN (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:AHLGREN
Last Name:KRUEGER
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 1:1511 W MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9556
Mailing Address - Country:US
Mailing Address - Phone:920-403-4600
Mailing Address - Fax:
Practice Address - Street 1:1511 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9556
Practice Address - Country:US
Practice Address - Phone:920-403-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5779 - 125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional