Provider Demographics
NPI:1952937351
Name:KUE, MINDY (LPC, SAC-IT)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:KUE
Suffix:
Gender:F
Credentials:LPC, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3332
Mailing Address - Country:US
Mailing Address - Phone:920-977-3111
Mailing Address - Fax:920-482-5662
Practice Address - Street 1:601 N 5TH ST STE 9
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4623
Practice Address - Country:US
Practice Address - Phone:920-977-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4111-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional