Provider Demographics
NPI:1649820168
Name:HOEHN, ELYSE (PC)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:HOEHN
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:ELYSE
Other - Middle Name:
Other - Last Name:HENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8649 INMAN AVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4713
Mailing Address - Country:US
Mailing Address - Phone:715-629-7469
Mailing Address - Fax:
Practice Address - Street 1:2501 HANLEY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8705
Practice Address - Country:US
Practice Address - Phone:534-544-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4472-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health