Provider Demographics
NPI:1700159217
Name:PROCHASKA, KAREN T (LPC-SAS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:T
Last Name:PROCHASKA
Suffix:
Gender:F
Credentials:LPC-SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1127
Mailing Address - Country:US
Mailing Address - Phone:920-849-1400
Mailing Address - Fax:920-849-1468
Practice Address - Street 1:206 COURT ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1127
Practice Address - Country:US
Practice Address - Phone:920-849-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5013-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional