Provider Demographics
NPI:1003574252
Name:KESSEN, TANYA L (LPC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:L
Last Name:KESSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 5TH AVE S STE 508
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4059
Mailing Address - Country:US
Mailing Address - Phone:608-492-0092
Mailing Address - Fax:
Practice Address - Street 1:205 5TH AVE S STE 508
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4059
Practice Address - Country:US
Practice Address - Phone:608-387-9638
Practice Address - Fax:608-377-7488
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5172-226101YP2500X
WI10851-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional