Provider Demographics
NPI:1508455304
Name:MACEK, CURTIS (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:MACEK
Suffix:
Gender:M
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W SUNNY LN
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-9091
Mailing Address - Country:US
Mailing Address - Phone:608-741-4500
Mailing Address - Fax:608-741-4502
Practice Address - Street 1:203 W SUNNY LN
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-9091
Practice Address - Country:US
Practice Address - Phone:608-741-4500
Practice Address - Fax:608-741-4502
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7260-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional