Provider Demographics
NPI:1396852919
Name:HOWLEY, KRISTINE L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:L
Last Name:HOWLEY
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 1:1813 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-6125
Mailing Address - Country:US
Mailing Address - Phone:920-459-1494
Mailing Address - Fax:414-964-4816
Practice Address - Street 1:1813 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-6125
Practice Address - Country:US
Practice Address - Phone:920-459-1494
Practice Address - Fax:414-964-4816
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1671-1201041C0700X
WI7059-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI001984452Medicare PIN