Provider Demographics
NPI:1609146703
Name:ADER, KARL J (LPC)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:J
Last Name:ADER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 25 1/4 AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-9423
Mailing Address - Country:US
Mailing Address - Phone:715-557-0093
Mailing Address - Fax:
Practice Address - Street 1:1425 2ND AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:WI
Practice Address - Zip Code:54829-7212
Practice Address - Country:US
Practice Address - Phone:715-557-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1367101YP2500X
WI1367-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1609146703Medicaid