Provider Demographics
NPI:1982877403
Name:POHLE, MAUREEN ANN (LPC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:POHLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 E DEVONSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1916
Mailing Address - Country:US
Mailing Address - Phone:262-894-3540
Mailing Address - Fax:262-303-4765
Practice Address - Street 1:1444 E DEVONSHIRE RD
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1916
Practice Address - Country:US
Practice Address - Phone:262-894-3540
Practice Address - Fax:262-303-4765
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3946-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43725200Medicaid