Provider Demographics
NPI:1932340437
Name:MARXEN, JOHN CLAUS (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CLAUS
Last Name:MARXEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 BERNHEIM ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8967
Mailing Address - Country:US
Mailing Address - Phone:920-279-6001
Mailing Address - Fax:
Practice Address - Street 1:3126 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-9258
Practice Address - Country:US
Practice Address - Phone:920-279-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3020-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health