Provider Demographics
NPI:1356658439
Name:BUEGE, EILENE S (LPC)
Entity Type:Individual
Prefix:
First Name:EILENE
Middle Name:S
Last Name:BUEGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EILENE
Other - Middle Name:S
Other - Last Name:NYQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6800 N 76TH ST
Mailing Address - Street 2:PO BOX 245039
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-5002
Mailing Address - Country:US
Mailing Address - Phone:414-368-6070
Mailing Address - Fax:414-368-6073
Practice Address - Street 1:6800 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-5002
Practice Address - Country:US
Practice Address - Phone:414-368-6070
Practice Address - Fax:414-368-6073
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI587-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional