Provider Demographics
NPI:1922170372
Name:NEUVILLE, MAUREEN A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:A
Last Name:NEUVILLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:A
Other - Last Name:BISSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:1005 OAK AVE N
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-2117
Mailing Address - Country:US
Mailing Address - Phone:608-780-2823
Mailing Address - Fax:608-781-2924
Practice Address - Street 1:115 5TH AVE S
Practice Address - Street 2:SUITE 507
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-9200
Practice Address - Country:US
Practice Address - Phone:608-780-2823
Practice Address - Fax:608-781-2924
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3599-125101YM0800X
MNLPC00916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40953700Medicaid