Provider Demographics
NPI:1649059189
Name:ZAIDEL, CARRIE BAKER (LPC)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:BAKER
Last Name:ZAIDEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:BAKER
Other - Last Name:LAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7385 COUNTY RD S
Mailing Address - Street 2:
Mailing Address - City:SOBIESKI
Mailing Address - State:WI
Mailing Address - Zip Code:54171-9777
Mailing Address - Country:US
Mailing Address - Phone:920-639-3991
Mailing Address - Fax:
Practice Address - Street 1:2701 LARSEN RD # BA106
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-4863
Practice Address - Country:US
Practice Address - Phone:920-639-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5794-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional