MRS. DEBORAH J KLECKER (NPI# 1255675112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255675112 |
| Entity Type | Individual |
| Full Name | MRS. DEBORAH J KLECKER |
| Credential | LPC, MFT-IT, SAC-IT |
| Practice Address |
970 S Silver Lake St Suite #103 Oconomowoc WI 53066-3802 |
| Mailing Address |
W6269 Train Rd Watertown WI 53098-3909 |
| Practice Telephone | 2625677377 |
| Practice Fax Number | 2625677377 |
| Mailing Telephone | 2628937870 |
| Mailing Fax Number | 2625677377 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2013-11-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15898-130 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
4958-125 | WI | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 178-228 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1255675112 | 05 |
| Street Address |
970 S SILVER LAKE ST SUITE #103 |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066-3802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036726 | Christian Zebrasky | Chiropractor | 970 S Silver Lake St, Suite 106, Oconomowoc, WI 53066-3802 | 2005-07-08 |
| 1164803631 | Kenzie Gaines Davidovich | Dentist | 970 S Silver Lake St, #101, Oconomowoc, WI 53066-3802 | 2015-06-10 |
| 1790978666 | Lake Country Pain Treatment | Specialist | 970 S Silver Lake St, Suite 106, Oconomowoc, WI 53066-3802 | 2007-08-23 |
| 1245245794 | A New Day Psychological Services LLC | Psychologist | 970 S Silver Lake St, Suite 103, Oconomowoc, WI 53066-3802 | 2006-07-30 |
| 1811914609 | Complete Chiropractic and Rehab Center LLC | Chiropractor | 970 S Silver Lake St, #106, Oconomowoc, WI 53066 | 2006-07-16 |
| 1144274689 | Bonita Jean Debban | Psychologist | 970 S Silver Lake St, Oconomowoc, WI 53066-3802 | 2006-05-20 |
| 1801849963 | Lake Country Pediatrics Sc | Pediatrics | 970 S Silver Lake St, Ste. 102, Oconomowoc, WI 53066-3802 | 2006-05-18 |
| 1124076658 | Timothy G. Williamson | Dentist | 970 S Silver Lake St, Oconomowoc, WI 53066-3802 | 2006-05-05 |
| 1619940947 | Gregory Michael Moyer | Pediatrics | 970 S Silver Lake St, Ste. 102, Oconomowoc, WI 53066-3802 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048029 | Kristen R Coffey | Counselor | 405 E Forest St, Oconomowoc, WI 53066-3707 | 2020-09-17 |
| 1124638069 | Brittney Schultz | Counselor | 405 E Forest St Ste 119, Oconomowoc, WI 53066-3707 | 2020-08-05 |
| 1356961775 | Amanda Donath Psychological Services S C | Counselor | 169 E Wisconsin Ave Unit G, Oconomowoc, WI 53066-3062 | 2020-04-26 |
| 1245700715 | Emily Enstad | Counselor | 405 E Forest St Ste 111, Oconomowoc, WI 53066-3707 | 2018-11-27 |
| 1104309772 | Ashley Feldman | Counselor | N53w37198 Madison St, Oconomowoc, WI 53066-5343 | 2018-09-10 |
| 1942722061 | Jennifer L Swanson | Counselor | 521 Westover St, Oconomowoc, WI 53066-3776 | 2017-07-11 |
| 1023481033 | Kelly Muston | Counselor | 1230 Corporate Center Dr, Suite 100, Oconomowoc, WI 53066-4883 | 2015-11-12 |
| 1275954828 | Faith Patrice Fanger | Counselor | 317 S Worthington St, Oconomowoc, WI 53066-3647 | 2013-12-29 |
| 1912209925 | Jeffrey W Stache | Counselor | 1200 Christopher Ct, Oconomowoc, WI 53066-2321 | 2010-11-23 |
| 1639211303 | Julie A Atabe | Counselor | 1002 Towerside Ct, Oconomowoc, WI 53066-3926 | 2007-02-12 |
| Find all providers in OCONOMOWOC | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
Please comment or provide details below to improve the information on MRS. DEBORAH J KLECKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.