Provider Demographics
NPI:1588858005
Name:RINDFLEISCH, TANYA (LPC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:RINDFLEISCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 N US HIGHWAY 51
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-0726
Mailing Address - Country:US
Mailing Address - Phone:608-758-8400
Mailing Address - Fax:608-758-8428
Practice Address - Street 1:3506 N US HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-0726
Practice Address - Country:US
Practice Address - Phone:608-758-8400
Practice Address - Fax:608-758-8428
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3539125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43738300Medicaid