Provider Demographics
NPI:1801223003
Name:NOLTE, EMILY M (CSAC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:NOLTE
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S COURT ST. ROOM 3000
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656
Mailing Address - Country:US
Mailing Address - Phone:608-269-8600
Mailing Address - Fax:608-269-8935
Practice Address - Street 1:112 S COURT ST. ROOM 3000
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656
Practice Address - Country:US
Practice Address - Phone:608-269-8600
Practice Address - Fax:608-269-8935
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15841101YA0400X
WI16250-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)