Provider Demographics
NPI:1326213976
Name:GOHR, SHEILA K (LPC, APSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:K
Last Name:GOHR
Suffix:
Gender:F
Credentials:LPC, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22308
Mailing Address - Street 2:300 CROOKS STREET
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305
Mailing Address - Country:US
Mailing Address - Phone:920-436-6800
Mailing Address - Fax:920-437-3540
Practice Address - Street 1:2945 SHAWANO AVENUE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54305
Practice Address - Country:US
Practice Address - Phone:920-436-6800
Practice Address - Fax:920-437-3540
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3546-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39700800Medicaid