Provider Demographics
NPI:1467723064
Name:DEUSTER, NATALIE M (MSW,LCSW,SAC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:DEUSTER
Suffix:
Gender:F
Credentials:MSW,LCSW,SAC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:M
Other - Last Name:BRESSERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSW,SAC
Mailing Address - Street 1:PO BOX 22040
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2040
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:1325 ANGELS PATH
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-4050
Practice Address - Country:US
Practice Address - Phone:920-338-2855
Practice Address - Fax:920-338-9270
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16119-132101YA0400X
WI8112-1231041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)