Basic Information
| Provider Information | |||||||||
| NPI: | 1528686813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAHLER | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | APSW- QTT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 199 COUNTY ROAD DF FL 3 | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530399512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9203863500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 199 COUNTY ROAD DF | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530399512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9203863500 | ||||||||
| FaxNumber: | 3203863812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2020 | ||||||||
| LastUpdateDate: | 08/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 131941-121 | WI | Y | Behavioral Health & Social Service Providers | Social Worker |
ID Information
| ID | Type | State | Issuer | Description | 1528686813 | 05 | WI | MEDICAID |