Provider Demographics
NPI:1609915123
Name:HESS, PATRICIA ANN (MSE, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:HESS
Suffix:
Gender:F
Credentials:MSE, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81286 CREAMERY RD
Mailing Address - Street 2:
Mailing Address - City:BUTTERNUT
Mailing Address - State:WI
Mailing Address - Zip Code:54514-8612
Mailing Address - Country:US
Mailing Address - Phone:715-769-3924
Mailing Address - Fax:715-769-3924
Practice Address - Street 1:8618 HIGHWAY 51N
Practice Address - Street 2:
Practice Address - City:MINOCQUA
Practice Address - State:WI
Practice Address - Zip Code:54548
Practice Address - Country:US
Practice Address - Phone:715-356-6146
Practice Address - Fax:715-358-9556
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3165-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI56043OtherSECURITY HEALTH PLAN ID#
WI43559300Medicaid