Provider Demographics
NPI:1952613135
Name:KROGER, SUMAYA ANNE (MS, LPC, SAC)
Entity Type:Individual
Prefix:MRS
First Name:SUMAYA
Middle Name:ANNE
Last Name:KROGER
Suffix:
Gender:F
Credentials:MS, LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9364 W LOOMIS RD
Mailing Address - Street 2:#3
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8243
Mailing Address - Country:US
Mailing Address - Phone:414-732-9404
Mailing Address - Fax:
Practice Address - Street 1:9364 W LOOMIS RD
Practice Address - Street 2:#3
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8243
Practice Address - Country:US
Practice Address - Phone:414-732-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15911-130101YA0400X
WI641-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)