Provider Demographics
NPI:1255739926
Name:PAWLAK, KRISTEN (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:PAWLAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:GREELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:8800 S 102ND ST
Mailing Address - Street 2:STE 103
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-7712
Mailing Address - Country:US
Mailing Address - Phone:414-858-1014
Mailing Address - Fax:
Practice Address - Street 1:8800 S 102ND ST
Practice Address - Street 2:STE 103
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-7712
Practice Address - Country:US
Practice Address - Phone:414-858-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7395-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical