Provider Demographics
NPI:1518024058
Name:AARDAPPEL, AUDREY LORRAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:LORRAINE
Last Name:AARDAPPEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 CALUMET DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083
Mailing Address - Country:US
Mailing Address - Phone:920-451-6908
Mailing Address - Fax:920-458-6439
Practice Address - Street 1:2801 CALUMET DRIVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083
Practice Address - Country:US
Practice Address - Phone:920-451-6098
Practice Address - Fax:920-458-6439
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6-123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39566400Medicaid
WI395664000Medicaid
WI60040-0118Medicare ID - Type Unspecified