Provider Demographics
NPI:1841776192
Name:GEHRKE, MARGARET ANN (CSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:GEHRKE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 GRACELAND DR
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7966
Mailing Address - Country:US
Mailing Address - Phone:920-573-1340
Mailing Address - Fax:
Practice Address - Street 1:130 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-3181
Practice Address - Country:US
Practice Address - Phone:920-784-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8128-120101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)