Provider Demographics
NPI:1407020712
Name:DREFKE, KATHRYN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:DREFKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:DREFKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:214 E SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4814
Mailing Address - Country:US
Mailing Address - Phone:906-734-2601
Mailing Address - Fax:906-727-1081
Practice Address - Street 1:214 E SUMMER ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4814
Practice Address - Country:US
Practice Address - Phone:906-734-2601
Practice Address - Fax:906-727-1081
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010901151041C0700X
WI7852-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical