Provider Demographics
NPI:1962865212
Name:PROSKI, JANICE EILEEN (LPC-IT)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:EILEEN
Last Name:PROSKI
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:YAHNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:926 WILLARD DR STE 136
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-5296
Mailing Address - Country:US
Mailing Address - Phone:920-461-5820
Mailing Address - Fax:888-449-6342
Practice Address - Street 1:926 WILLARD DR STE 136
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5296
Practice Address - Country:US
Practice Address - Phone:920-461-5820
Practice Address - Fax:888-449-6342
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1962865212Medicaid