Provider Demographics
NPI:1659301141
Name:PRZYWOJOSKI, KAY E (LPC CADCIII)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:E
Last Name:PRZYWOJOSKI
Suffix:
Gender:F
Credentials:LPC CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WEST AVENUE SOUTH
Mailing Address - Street 2:ATTN PHYSICIAN SERVICES
Mailing Address - City:LACROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601
Mailing Address - Country:US
Mailing Address - Phone:608-791-4156
Mailing Address - Fax:608-791-9898
Practice Address - Street 1:325 BUTTS AVENUE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1412
Practice Address - Country:US
Practice Address - Phone:608-372-5999
Practice Address - Fax:609-372-3436
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1400101YA0400X
WI3112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39343400Medicaid