Provider Demographics
NPI:1518492057
Name:NADELHOFFER, CARRIE (LPC-IT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:NADELHOFFER
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13447 W COUNTY ROAD B STE 1
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-2260
Mailing Address - Country:US
Mailing Address - Phone:715-558-7883
Mailing Address - Fax:715-558-7589
Practice Address - Street 1:15655 W COUNTY HIGHWAY B
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-2680
Practice Address - Country:US
Practice Address - Phone:715-699-1500
Practice Address - Fax:715-699-1503
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
WI20358-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional