Provider Demographics
NPI:1295481851
Name:WOGER, ELIZABETH I (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:I
Last Name:WOGER
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 1:2949A N 68TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1208
Mailing Address - Country:US
Mailing Address - Phone:715-551-7078
Mailing Address - Fax:
Practice Address - Street 1:5650 N GREEN BAY AVE STE 205
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-4446
Practice Address - Country:US
Practice Address - Phone:715-551-7078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8187-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional