Provider Demographics
NPI:1740855675
Name:WAWIORKA, NATOSHIA (APSW, CSAC)
Entity type:Individual
Prefix:
First Name:NATOSHIA
Middle Name:
Last Name:WAWIORKA
Suffix:
Gender:F
Credentials:APSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 RAMADA WAY
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-5700
Mailing Address - Country:US
Mailing Address - Phone:920-497-6200
Mailing Address - Fax:
Practice Address - Street 1:2830 RAMADA WAY
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5700
Practice Address - Country:US
Practice Address - Phone:920-497-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI134952104100000X
WI17117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker