Provider Demographics
NPI:1912894262
Name:DZIEGIELEWSKI, MARY CATHERINE (MS, LPC-IT, ATR-P)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:DZIEGIELEWSKI
Suffix:
Gender:F
Credentials:MS, LPC-IT, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6229 W GOODRICH LN
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-3420
Mailing Address - Country:US
Mailing Address - Phone:920-470-0737
Mailing Address - Fax:920-470-0737
Practice Address - Street 1:2314 N GRANDVIEW BLVD STE 207
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1675
Practice Address - Country:US
Practice Address - Phone:262-251-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health