Provider Demographics
NPI:1699839290
Name:CESARIO, DEBRA JEAN (LPC)
Entity Type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:JEAN
Last Name:CESARIO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:JEAN
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1011 N MAYFAIR RD
Mailing Address - Street 2:304
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3431
Mailing Address - Country:US
Mailing Address - Phone:414-453-8380
Mailing Address - Fax:414-443-1635
Practice Address - Street 1:1011 N MAYFAIR RD
Practice Address - Street 2:304
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3431
Practice Address - Country:US
Practice Address - Phone:414-453-8380
Practice Address - Fax:414-443-1635
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2900-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43582900Medicaid