Provider Demographics
NPI:1427377688
Name:SOEHNLEIN, PAULA (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SOEHNLEIN
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, LPC
Mailing Address - Street 1:5585 BRENDAN AVE
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-6427
Mailing Address - Country:US
Mailing Address - Phone:920-277-9458
Mailing Address - Fax:
Practice Address - Street 1:2961 YARMOUTH GREENWAY DR STE 2
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-709-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WI5223-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health