Provider Demographics
NPI:1497234256
Name:AQUEEL, MEHWISH (MSC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MEHWISH
Middle Name:
Last Name:AQUEEL
Suffix:
Gender:F
Credentials:MSC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7537
Mailing Address - Country:US
Mailing Address - Phone:262-221-0945
Mailing Address - Fax:
Practice Address - Street 1:9916 75TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7583
Practice Address - Country:US
Practice Address - Phone:262-484-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-12
Last Update Date:2018-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010488101YP2500X
WI6594-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional