Provider Demographics
NPI:1508493370
Name:STRACK, WHITNEY (LPC-IT, NCC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:STRACK
Suffix:
Gender:F
Credentials:LPC-IT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2710
Mailing Address - Country:US
Mailing Address - Phone:920-660-9649
Mailing Address - Fax:
Practice Address - Street 1:N3219 COUNTY TRUNK H STE E
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-7074
Practice Address - Country:US
Practice Address - Phone:262-729-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health