Provider Demographics
NPI:1639703242
Name:ROBERSON, KRISSA ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISSA
Middle Name:ANN
Last Name:ROBERSON
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:PO BOX 23400
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2144
Mailing Address - Country:US
Mailing Address - Phone:920-433-7411
Mailing Address - Fax:
Practice Address - Street 1:1325 ANGELS PATH
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-4050
Practice Address - Country:US
Practice Address - Phone:920-338-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health