Provider Demographics
NPI:1407397870
Name:WOEST, JOHN J (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:WOEST
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2733 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-5513
Mailing Address - Country:US
Mailing Address - Phone:920-497-6200
Mailing Address - Fax:920-497-3135
Practice Address - Street 1:2733 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5513
Practice Address - Country:US
Practice Address - Phone:920-497-6200
Practice Address - Fax:920-497-3135
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1122-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health