Provider Demographics
NPI:1710908405
Name:KALENSKY, SUSAN M (LPC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:KALENSKY
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 1:18000 W SARAH LN STE 210
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5840
Mailing Address - Country:US
Mailing Address - Phone:262-267-8551
Mailing Address - Fax:262-395-4047
Practice Address - Street 1:18000 W SARAH LN STE 210
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5840
Practice Address - Country:US
Practice Address - Phone:262-267-8551
Practice Address - Fax:262-395-4047
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15502-131101YA0400X
WI3737-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40928700Medicaid