Provider Demographics
NPI:1669823381
Name:GUENTHER-PAL, ANDREA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GUENTHER-PAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 S NICOLET RD STE 1
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-8270
Mailing Address - Country:US
Mailing Address - Phone:920-944-9700
Mailing Address - Fax:920-570-6990
Practice Address - Street 1:477 S NICOLET RD STE 1
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-8270
Practice Address - Country:US
Practice Address - Phone:920-944-9700
Practice Address - Fax:920-570-6990
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8865-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical