Koebernik, Katie

Koebernik, Katie is an individual health care provider with primary practice located at 424 S Monroe Ave Ste 201 , Green Bay WI 54301-4054. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Koebernik, Katie can be contacted via phone (920) 445-0170.

Contact Information

Primary practice address
424 S Monroe Ave Ste 201 Green Bay WI 54301-4054
Phone: (920) 445-0170
Fax: (920) 445-0174
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 18335-130 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2593-226 Wisconsin

Profile Details

NPI number 1427421023
LBN Legal business name Koebernik, Katie
Credentials LPC-IT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2015
Last updated Oct 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427421023 NPPES
Wisconsin MEDICAID 1427421023

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