Provider Demographics
NPI:1225899222
Name:WACHOWIAK, NATALIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:WACHOWIAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 W MAPLERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-5104
Mailing Address - Country:US
Mailing Address - Phone:847-345-9326
Mailing Address - Fax:
Practice Address - Street 1:497 W MAPLERIDGE DR
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-5104
Practice Address - Country:US
Practice Address - Phone:847-345-9326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11568-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical