Provider Demographics
NPI:1932146214
Name:KEGELMEYER, M. KAREN (MS, LPCC AND LPC)
Entity Type:Individual
Prefix:
First Name:M. KAREN
Middle Name:
Last Name:KEGELMEYER
Suffix:
Gender:F
Credentials:MS, LPCC AND LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 N 76TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-4732
Mailing Address - Country:US
Mailing Address - Phone:414-810-7790
Mailing Address - Fax:414-358-5005
Practice Address - Street 1:4757 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4732
Practice Address - Country:US
Practice Address - Phone:414-810-7790
Practice Address - Fax:414-358-5005
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0002209101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor